ReceivedClaimFact
The received claim fact contains header-level information about claims received from payers that are being processed, have been paid, or have been denied. Columns contain information considered accurate by the payer, so this data is intended for use in cost and quality analytics. Each row represents a received claim, which can be an original, reversal, or adjustment claim.
For claims data loaded from Clarity, columns can contain either data as received from the sender or as currently stored. Received information is used when there is no common workflow for the payer to change the received data. For example, received data is preferred for billing provider. Current data is preferred for information calculated by the payer, such as payment amounts, or when there is a valid workflow during which the payer might alter the received version of the claim, such as changing the diagnosis or procedure during code editing. All received claims, except voided, reprice, and intermediate claims, are loaded, including unpaid claims.
Properties
- Reporting table name
- dbo.ReceivedClaimFact
- Granularity
- A received claim, which can be an original, reversal, or adjustment claim
- Profile tables
- none
- Links to
-
- ContractBridge
- ContractDim
- ContractDimSourceData
- CoverageDim
- DateDim
- DepartmentBridge
- DepartmentDim
- DiagnosisBridge
- DiagnosisDim
- DrgDim
- LineOfBusinessDim
- PatientDim
- PatientDimSourceData
- PlaceOfServiceDim
- ProcedureDim
- ProcedureTerminologyBridge
- ProviderDim
- ProviderDimSourceData
- ReceivedClaimFact
- SourceDim
- VendorDim
- Links from
-
- AccumulationInstanceFact
- ApClaimActionFact
- ApClaimFact
- ApClaimProcessingCodeAuditFact
- ApClaimWorkqueueItemFact
- InterfaceLoadedClaimFact
- ManagedCareTransactionFact
- QdmDiagnosisEventFact
- QdmDiagnosticStudyPerformedEventFact
- QdmEncounterPerformedDiagnosisFact
- QdmEncounterPerformedSetDataMart
- QdmImmunizationAdministeredEventFact
- QdmInterventionPerformedEventFact
- QdmPhysicalExamPerformedEventFact
- QdmProcedurePerformedEventFact
- QdmSymptomEventFact
- QmEncounterClaimMappingFact
- QmEncounterIdentifierFact
- ReceivedClaimAnalyticsDataMart
- ReceivedClaimAttributeValueDim
- ReceivedClaimMedicationFact
- ReceivedClaimProcedureFact
- ReceivedClaimReferralMappingFact
- ValueBasedPaymentEventFact
- Snapshot on data change
- Disabled
Columns
ReceivedClaimKey
: integerSurrogate key used to uniquely identify the record
Properties
- Data type
- integer
- SQL Server data type
- bigint
- Allows null
- No
OriginalClaimKey
: integerOriginal claim in the adjustment sequence
Properties
- Data type
- integer
- SQL Server data type
- bigint
- Allows null
- No
- Default value
- -1
- Delete value
- -3
Data Lineage for Each Package
CMS ACO Part A Files Load
| OriginalClaimId |
NULL |
| OriginalClaimIdType |
"NotApplicable" |
CMS ACO Part B DME File Load
| OriginalClaimId |
NULL |
| OriginalClaimIdType |
"NotApplicable" |
CMS ACO Part B Physicians File Load
| OriginalClaimId |
NULL |
| OriginalClaimIdType |
"NotApplicable" |
CMS ACO Part D Prescription Drug File Load
| OriginalClaimId |
NULL |
| OriginalClaimIdType |
"NotApplicable" |
CMS CJR DME Claim Load
| OriginalClaimId |
NULL |
| OriginalClaimIdType |
"NotApplicable" |
CMS CJR Home Health Claim Load
| OriginalClaimId |
NULL |
| OriginalClaimIdType |
"NotApplicable" |
CMS CJR Hospice Claim Load
| OriginalClaimId |
NULL |
| OriginalClaimIdType |
"NotApplicable" |
CMS CJR Inpatient Claim Load
| OriginalClaimId |
NULL |
| OriginalClaimIdType |
"NotApplicable" |
CMS CJR Outpatient Claim Load
| OriginalClaimId |
NULL |
| OriginalClaimIdType |
"NotApplicable" |
CMS CJR Part B Claim Load
| OriginalClaimId |
NULL |
| OriginalClaimIdType |
"NotApplicable" |
CMS CJR Skilled Nursing Facility Claim Load
| OriginalClaimId |
NULL |
| OriginalClaimIdType |
"NotApplicable" |
Data Aggregation Medical Claim Load
| OriginalClaimId |
NULL |
| OriginalClaimIdType |
"NotApplicable" |
Data Aggregation Pharmacy Claim Load
| OriginalClaimId | |
| OriginalClaimIdType |
"NotApplicable" |
Externally Adjudicated Medical Claim Load
| OriginalClaimId |
NULL |
| OriginalClaimIdType |
"NotApplicable" |
Externally Adjudicated Pharmacy Claim Load
| OriginalClaimId | |
| OriginalClaimIdType |
"NotApplicable" |
Payer System Medical Claim Load
| OriginalClaimId |
NULL |
| OriginalClaimIdType |
"NotApplicable" |
Payer System Pharmacy Claim Load
| OriginalClaimId | |
| OriginalClaimIdType |
"NotApplicable" |
Received Claim Load
| OriginalClaimId |
NULL |
| OriginalClaimIdType |
"NotApplicable" |
Received Pharmacy Claim Load
| OriginalClaimId | |
| OriginalClaimIdType |
"NotApplicable" |
AdjustmentToClaimKey
: integerPrevious claim to which this claim is an adjustment
Properties
- Data type
- integer
- SQL Server data type
- bigint
- Allows null
- No
- Default value
- -1
- Delete value
- -3
Data Lineage for Each Package
CMS ACO Part A Files Load
| AdjustmentToClaimId |
NULL |
| AdjustmentToClaimIdType |
"NotApplicable" |
CMS ACO Part B DME File Load
| AdjustmentToClaimId |
NULL |
| AdjustmentToClaimIdType |
"NotApplicable" |
CMS ACO Part B Physicians File Load
| AdjustmentToClaimId |
NULL |
| AdjustmentToClaimIdType |
"NotApplicable" |
CMS ACO Part D Prescription Drug File Load
| AdjustmentToClaimId |
NULL |
| AdjustmentToClaimIdType |
"NotApplicable" |
CMS CJR DME Claim Load
| AdjustmentToClaimId |
NULL |
| AdjustmentToClaimIdType |
NotApplicable |
CMS CJR Home Health Claim Load
| AdjustmentToClaimId |
NULL |
| AdjustmentToClaimIdType |
NotApplicable |
CMS CJR Hospice Claim Load
| AdjustmentToClaimId |
NULL |
| AdjustmentToClaimIdType |
NotApplicable |
CMS CJR Inpatient Claim Load
| AdjustmentToClaimId |
NULL |
| AdjustmentToClaimIdType |
NotApplicable |
CMS CJR Outpatient Claim Load
| AdjustmentToClaimId |
NULL |
| AdjustmentToClaimIdType |
NotApplicable |
CMS CJR Part B Claim Load
| AdjustmentToClaimId |
NULL |
| AdjustmentToClaimIdType |
NotApplicable |
CMS CJR Skilled Nursing Facility Claim Load
| AdjustmentToClaimId |
NULL |
| AdjustmentToClaimIdType |
NotApplicable |
Data Aggregation Medical Claim Load
| AdjustmentToClaimId |
|
||||||
|
If AP_CLAIM.ORIG_ADJST_CLM_ID is not NULL then AP_CLAIM.ORIG_ADJST_CLM_ID Otherwise if AP_CLAIM.REV_CLM_ID is NULL then AP_CLAIM_2.ORIG_ACT_ADJ_CLM_ID Otherwise NULL |
|||||||
| AdjustmentToClaimIdType |
|
||||||
|
"EpicExternallyPaidClaimDataAggId" |
Data Aggregation Pharmacy Claim Load
| AdjustmentToClaimId |
|
||
| AdjustmentToClaimIdType |
"EpicExternallyPaidPharmacyClaimDataAggId" |
Externally Adjudicated Medical Claim Load
| AdjustmentToClaimId |
|
||
| AdjustmentToClaimIdType |
"EpicExternalPaidClaimInformationId" |
Externally Adjudicated Pharmacy Claim Load
| AdjustmentToClaimId |
|
||
| AdjustmentToClaimIdType |
"EpicExternalPaidPharmacyClaimInformationId" |
Payer System Medical Claim Load
| AdjustmentToClaimId |
|
||||||
|
If AP_CLAIM.ORIG_ADJST_CLM_ID is not NULL then AP_CLAIM.ORIG_ADJST_CLM_ID Otherwise if AP_CLAIM.REV_CLM_ID is NULL then AP_CLAIM_2.ORIG_ACT_ADJ_CLM_ID Otherwise NULL |
|||||||
| AdjustmentToClaimIdType |
|
||||||
|
"EpicExternalPaidPayerSystemClaimId" |
Payer System Pharmacy Claim Load
| AdjustmentToClaimId |
|
||
| AdjustmentToClaimIdType |
"EpicExternalPaidPayerSystemPharmacyClaimId" |
Received Claim Load
| AdjustmentToClaimId |
|
||||||
|
If AP_CLAIM.ORIG_ADJST_CLM_ID is not NULL then AP_CLAIM.ORIG_ADJST_CLM_ID Otherwise if AP_CLAIM.REV_CLM_ID is NULL then AP_CLAIM_2.ORIG_ACT_ADJ_CLM_ID Otherwise NULL |
|||||||
| AdjustmentToClaimIdType |
"EpicClaimInformationId" |
Received Pharmacy Claim Load
| AdjustmentToClaimId |
|
||
| AdjustmentToClaimIdType |
"EpicPharmacyClaimInformationId" |
ReversalToClaimKey
: integerPrevious claim to which this claim is a reversal
Properties
- Data type
- integer
- SQL Server data type
- bigint
- Allows null
- No
- Default value
- -1
- Delete value
- -3
Data Lineage for Each Package
CMS ACO Part A Files Load
| ReversalToClaimId |
NULL |
| ReversalToClaimIdType |
"NotApplicable" |
CMS ACO Part B DME File Load
| ReversalToClaimId |
NULL |
| ReversalToClaimIdType |
"NotApplicable" |
CMS ACO Part B Physicians File Load
| ReversalToClaimId |
NULL |
| ReversalToClaimIdType |
"NotApplicable" |
CMS ACO Part D Prescription Drug File Load
| ReversalToClaimId |
NULL |
| ReversalToClaimIdType |
"NotApplicable" |
CMS CJR DME Claim Load
| ReversalToClaimId |
NULL |
| ReversalToClaimIdType |
NotApplicable |
CMS CJR Home Health Claim Load
| ReversalToClaimId |
NULL |
| ReversalToClaimIdType |
NotApplicable |
CMS CJR Hospice Claim Load
| ReversalToClaimId |
NULL |
| ReversalToClaimIdType |
NotApplicable |
CMS CJR Inpatient Claim Load
| ReversalToClaimId |
NULL |
| ReversalToClaimIdType |
NotApplicable |
CMS CJR Outpatient Claim Load
| ReversalToClaimId |
NULL |
| ReversalToClaimIdType |
NotApplicable |
CMS CJR Part B Claim Load
| ReversalToClaimId |
NULL |
| ReversalToClaimIdType |
NotApplicable |
CMS CJR Skilled Nursing Facility Claim Load
| ReversalToClaimId |
NULL |
| ReversalToClaimIdType |
NotApplicable |
Data Aggregation Medical Claim Load
| ReversalToClaimId |
|
||
| ReversalToClaimIdType |
|
||
|
"EpicExternallyPaidClaimDataAggId" |
Data Aggregation Pharmacy Claim Load
| ReversalToClaimId |
|
||
| ReversalToClaimIdType |
"EpicExternallyPaidPharmacyClaimDataAggId" |
Externally Adjudicated Medical Claim Load
| ReversalToClaimId |
|
||
| ReversalToClaimIdType |
"EpicExternalPaidClaimInformationId" |
Externally Adjudicated Pharmacy Claim Load
| ReversalToClaimId |
|
||
| ReversalToClaimIdType |
"EpicExternalPaidPharmacyClaimInformationId" |
Payer System Medical Claim Load
| ReversalToClaimId |
|
||
| ReversalToClaimIdType |
|
||
|
"EpicExternalPaidPayerSystemClaimId" |
Payer System Pharmacy Claim Load
| ReversalToClaimId |
|
||
| ReversalToClaimIdType |
"EpicExternalPaidPayerSystemPharmacyClaimId" |
Received Claim Load
| ReversalToClaimId |
|
||
| ReversalToClaimIdType |
"EpicClaimInformationId" |
Received Pharmacy Claim Load
| ReversalToClaimId |
|
||
| ReversalToClaimIdType |
"EpicPharmacyClaimInformationId" |
AdjustedByClaimKey
: integerClaim which adjusts this claim
Properties
- Data type
- integer
- SQL Server data type
- bigint
- Allows null
- No
- Default value
- -1
- Delete value
- -3
Data Lineage for Each Package
CMS ACO Part A Files Load
| AdjustedByClaimId |
NULL |
| AdjustedByClaimIdType |
"NotApplicable" |
CMS ACO Part B DME File Load
| AdjustedByClaimId |
NULL |
| AdjustedByClaimIdType |
"NotApplicable" |
CMS ACO Part B Physicians File Load
| AdjustedByClaimId |
NULL |
| AdjustedByClaimIdType |
"NotApplicable" |
CMS ACO Part D Prescription Drug File Load
| AdjustedByClaimId |
NULL |
| AdjustedByClaimIdType |
"NotApplicable" |
CMS CJR DME Claim Load
| AdjustedByClaimId |
NULL |
| AdjustedByClaimIdType |
NotApplicable |
CMS CJR Home Health Claim Load
| AdjustedByClaimId |
NULL |
| AdjustedByClaimIdType |
NotApplicable |
CMS CJR Hospice Claim Load
| AdjustedByClaimId |
NULL |
| AdjustedByClaimIdType |
NotApplicable |
CMS CJR Inpatient Claim Load
| AdjustedByClaimId |
NULL |
| AdjustedByClaimIdType |
NotApplicable |
CMS CJR Outpatient Claim Load
| AdjustedByClaimId |
NULL |
| AdjustedByClaimIdType |
NotApplicable |
CMS CJR Part B Claim Load
| AdjustedByClaimId |
NULL |
| AdjustedByClaimIdType |
NotApplicable |
CMS CJR Skilled Nursing Facility Claim Load
| AdjustedByClaimId |
NULL |
| AdjustedByClaimIdType |
NotApplicable |
Data Aggregation Medical Claim Load
| AdjustedByClaimId |
|
||||||||||||||
|
If there exists any claim with AP_CLAIM.STATUS_C of 1-New, 2-Pending, 3-Denied, or 4-Clean and AP_CLAIM.ORIG_ADJST_CLM_ID is NULL and AP_CLAIM.ORIG_REV_CLM_ID is NULL and AP_CLAIM_2.ORIG_ACT_ADJ_CLM_ID = AP_CLAIM.CLAIM_ID of this row then the maximum AP_CLAIM.CLAIM_ID of that set Otherwise AP_CLAIM.ADJST_CLM_ID |
|||||||||||||||
| AdjustedByClaimIdType |
|
||||||||||||||
|
"EpicExternallyPaidClaimDataAggId" |
Data Aggregation Pharmacy Claim Load
| AdjustedByClaimId |
|
||
| AdjustedByClaimIdType |
"EpicExternallyPaidPharmacyClaimDataAggId" |
Externally Adjudicated Medical Claim Load
| AdjustedByClaimId |
|
||
| AdjustedByClaimIdType |
"EpicExternalPaidClaimInformationId" |
Externally Adjudicated Pharmacy Claim Load
| AdjustedByClaimId |
|
||
| AdjustedByClaimIdType |
"EpicExternalPaidPharmacyClaimInformationId" |
Payer System Medical Claim Load
| AdjustedByClaimId |
|
||||||||||||||
|
If there exists any claim with AP_CLAIM.STATUS_C of 1-New, 2-Pending, 3-Denied, or 4-Clean and AP_CLAIM.ORIG_ADJST_CLM_ID is NULL and AP_CLAIM.ORIG_REV_CLM_ID is NULL and AP_CLAIM_2.ORIG_ACT_ADJ_CLM_ID = AP_CLAIM.CLAIM_ID of this row then the maximum AP_CLAIM.CLAIM_ID of that set Otherwise AP_CLAIM.ADJST_CLM_ID |
|||||||||||||||
| AdjustedByClaimIdType |
|
||||||||||||||
|
"EpicExternalPaidPayerSystemClaimId" |
Payer System Pharmacy Claim Load
| AdjustedByClaimId |
|
||
| AdjustedByClaimIdType |
"EpicExternalPaidPayerSystemPharmacyClaimId" |
Received Claim Load
| AdjustedByClaimId |
|
||||||||||||||
|
If there exists any claim with AP_CLAIM.STATUS_C of 1-New, 2-Pending, 3-Denied, or 4-Clean and AP_CLAIM.ORIG_ADJST_CLM_ID is NULL and AP_CLAIM.ORIG_REV_CLM_ID is NULL and AP_CLAIM_2.ORIG_ACT_ADJ_CLM_ID = AP_CLAIM.CLAIM_ID of this row then the maximum AP_CLAIM.CLAIM_ID of that set Otherwise AP_CLAIM.ADJST_CLM_ID |
|||||||||||||||
| AdjustedByClaimIdType |
"EpicClaimInformationId" |
Received Pharmacy Claim Load
| AdjustedByClaimId |
|
||
| AdjustedByClaimIdType |
"EpicPharmacyClaimInformationId" |
ReversedByClaimKey
: integerClaim which reverses this claim
Properties
- Data type
- integer
- SQL Server data type
- bigint
- Allows null
- No
- Default value
- -1
- Delete value
- -3
Data Lineage for Each Package
CMS ACO Part A Files Load
| ReversedByClaimId |
NULL |
| ReversedByClaimIdType |
"NotApplicable" |
CMS ACO Part B DME File Load
| ReversedByClaimId |
NULL |
| ReversedByClaimIdType |
"NotApplicable" |
CMS ACO Part B Physicians File Load
| ReversedByClaimId |
NULL |
| ReversedByClaimIdType |
"NotApplicable" |
CMS ACO Part D Prescription Drug File Load
| ReversedByClaimId |
NULL |
| ReversedByClaimIdType |
"NotApplicable" |
CMS CJR DME Claim Load
| ReversedByClaimId |
NULL |
| ReversedByClaimIdType |
"NotApplicable" |
CMS CJR Home Health Claim Load
| ReversedByClaimId |
NULL |
| ReversedByClaimIdType |
"NotApplicable" |
CMS CJR Hospice Claim Load
| ReversedByClaimId |
NULL |
| ReversedByClaimIdType |
"NotApplicable" |
CMS CJR Inpatient Claim Load
| ReversedByClaimId |
NULL |
| ReversedByClaimIdType |
"NotApplicable" |
CMS CJR Outpatient Claim Load
| ReversedByClaimId |
NULL |
| ReversedByClaimIdType |
"NotApplicable" |
CMS CJR Part B Claim Load
| ReversedByClaimId |
NULL |
| ReversedByClaimIdType |
"NotApplicable" |
CMS CJR Skilled Nursing Facility Claim Load
| ReversedByClaimId |
NULL |
| ReversedByClaimIdType |
"NotApplicable" |
Data Aggregation Medical Claim Load
| ReversedByClaimId |
|
||||
| ReversedByClaimIdType |
|
||||
|
"EpicExternallyPaidClaimDataAggId" |
Data Aggregation Pharmacy Claim Load
| ReversedByClaimId |
|
||
| ReversedByClaimIdType |
"EpicExternallyPaidPharmacyClaimDataAggId" |
Externally Adjudicated Medical Claim Load
| ReversedByClaimId |
|
||||
| ReversedByClaimIdType |
"EpicExternalPaidClaimInformationId" |
Externally Adjudicated Pharmacy Claim Load
| ReversedByClaimId |
|
||
| ReversedByClaimIdType |
"EpicExternalPaidPharmacyClaimInformationId" |
Payer System Medical Claim Load
| ReversedByClaimId |
|
||||
| ReversedByClaimIdType |
|
||||
|
"EpicExternalPaidPayerSystemClaimId" |
Payer System Pharmacy Claim Load
| ReversedByClaimId |
|
||
| ReversedByClaimIdType |
"EpicExternalPaidPayerSystemPharmacyClaimId" |
Received Claim Load
| ReversedByClaimId |
|
||||
| ReversedByClaimIdType |
"EpicClaimInformationId" |
Received Pharmacy Claim Load
| ReversedByClaimId |
|
||
| ReversedByClaimIdType |
"EpicPharmacyClaimInformationId" |
PayerClaimId
: stringClaim Id as assigned by the payer
Properties
- Data type
- string
- SQL Server data type
- nvarchar(100)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| PayerClaimId |
|
||
CMS ACO Part B DME File Load
| PayerClaimId |
|
||
CMS ACO Part B Physicians File Load
| PayerClaimId |
|
||
CMS ACO Part D Prescription Drug File Load
| PayerClaimId |
|
||
CMS CJR DME Claim Load
| PayerClaimId |
|
||||||||
|
GEO_BENE_SK|CLM_DT_SGNTR_SK|CLM_TYPE_CD|CLM_NUM_SK |
CMS CJR Home Health Claim Load
| PayerClaimId |
|
||||||||
|
GEO_BENE_SK|CLM_DT_SGNTR_SK|CLM_TYPE_CD|CLM_NUM_SK |
CMS CJR Hospice Claim Load
| PayerClaimId |
|
||||||||
|
GEO_BENE_SK|CLM_DT_SGNTR_SK|CLM_TYPE_CD|CLM_NUM_SK |
CMS CJR Inpatient Claim Load
| PayerClaimId |
|
||||||||
|
GEO_BENE_SK|CLM_DT_SGNTR_SK|CLM_TYPE_CD|CLM_NUM_SK |
CMS CJR Outpatient Claim Load
| PayerClaimId |
|
||||||||
|
GEO_BENE_SK|CLM_DT_SGNTR_SK|CLM_TYPE_CD|CLM_NUM_SK |
CMS CJR Part B Claim Load
| PayerClaimId |
|
||||||||
|
GEO_BENE_SK|CLM_DT_SGNTR_SK|CLM_TYPE_CD|CLM_NUM_SK |
CMS CJR Skilled Nursing Facility Claim Load
| PayerClaimId |
|
||||||||
|
GEO_BENE_SK|CLM_DT_SGNTR_SK|CLM_TYPE_CD|CLM_NUM_SK |
Data Aggregation Medical Claim Load
| PayerClaimId |
|
||
Data Aggregation Pharmacy Claim Load
| PayerClaimId |
|
||
Externally Adjudicated Medical Claim Load
| PayerClaimId |
|
||
|
CLM_VALUES.ICN |
Externally Adjudicated Pharmacy Claim Load
| PayerClaimId |
|
||
|
CLM_VALUES.ICN |
Payer System Medical Claim Load
| PayerClaimId |
|
||
Payer System Pharmacy Claim Load
| PayerClaimId |
|
||
Received Claim Load
| PayerClaimId |
|
||||||
|
If AP_CLAIM.WORKFLOW_C IN ( 4, 5 ) then AP_CLAIM.ACCT_NUM_WITH_VEN Otherwise AP_CLAIM.CLAIM_ID |
Received Pharmacy Claim Load
| PayerClaimId |
|
||
|
AP_CLM_RX.CLAIM_ID |
PatientKey
: integerPatient associated with the claim
Properties
- Data type
- integer
- SQL Server data type
- bigint
- Allows null
- No
- Default value
- -1
- Delete value
- -3
Data Lineage for Each Package
CMS ACO Part A Files Load
| PatientId |
|
||
|
The preferred id will be used from "BENE_HIC_NUM" if populated; otherwise the fallback id will be used from "MBI" |
|||
| PatientIdType |
The preferred id type "EpicPatientHicn" if the column "BENE_HIC_NUM" is populated Otherwise "EpicPatientMbi" will be used with the value from the column "MBI" |
||
| StartDate |
|
||
|
If CLM_FROM_DT < 1/1/1753 or CLM_FROM_DT = 12/31/9999 then NULL Otherwise CLM_FROM_DT |
CMS ACO Part B DME File Load
| PatientId |
|
||
|
The preferred id will be used from "BENE_HIC_NUM" if populated; otherwise the fallback id will be used from "MBI" |
|||
| PatientIdType |
The preferred id type "EpicPatientHicn" if the column "BENE_HIC_NUM" is populated Otherwise "EpicPatientMbi" will be used with the value from the column "MBI" |
||
| StartDate |
|
||
|
If CLM_FROM_DT < 1/1/1753 or CLM_FROM_DT = 12/31/9999 then NULL Otherwise CLM_FROM_DT |
CMS ACO Part B Physicians File Load
| PatientId |
|
||
|
The preferred id will be used from "BENE_HIC_NUM" if populated; otherwise the fallback id will be used from "MBI" |
|||
| PatientIdType |
The preferred id type "EpicPatientHicn" if the column "BENE_HIC_NUM" is populated Otherwise "EpicPatientMbi" will be used with the value from the column "MBI" |
||
| StartDate |
|
||
|
If CLM_FROM_DT < 1/1/1753 or CLM_FROM_DT = 12/31/9999 then NULL Otherwise CLM_FROM_DT |
CMS ACO Part D Prescription Drug File Load
| PatientId |
|
||
| PatientIdType |
"EpicPatientHicn" |
||
| StartDate |
|
||
|
If CLM_LINE_FROM_DT < 1/1/1753 or CLM_LINE_FROM_DT = 12/31/9999 then NULL Otherwise CLM_LINE_FROM_DT |
CMS CJR DME Claim Load
| PatientId |
|
||
| PatientIdType |
IdrBeneficiaryKey |
||
| StartDate |
|
||
CMS CJR Home Health Claim Load
| PatientId |
|
||
| PatientIdType |
IdrBeneficiaryKey |
||
| StartDate |
|
||
CMS CJR Hospice Claim Load
| PatientId |
|
||
| PatientIdType |
IdrBeneficiaryKey |
||
| StartDate |
|
||
CMS CJR Inpatient Claim Load
| PatientId |
|
||
| PatientIdType |
IdrBeneficiaryKey |
||
| StartDate |
|
||
CMS CJR Outpatient Claim Load
| PatientId |
|
||
| PatientIdType |
IdrBeneficiaryKey |
||
| StartDate |
|
||
CMS CJR Part B Claim Load
| PatientId |
|
||
| PatientIdType |
IdrBeneficiaryKey |
||
| StartDate |
|
||
CMS CJR Skilled Nursing Facility Claim Load
| PatientId |
|
||
| PatientIdType |
IdrBeneficiaryKey |
||
| StartDate |
|
||
Data Aggregation Medical Claim Load
| PatientId |
|
||||
|
If PAT_ID is NULL then IDENT_BUNDLE_ID Otherwise PAT_ID |
|||||
| PatientIdType |
|
||||
|
If PAT_ID is NULL then "EpicExternalIDBundleID" Otherwise "EpicPatientId" |
|||||
| StartDate |
|
||||
|
Minimum of STMT_COV_FROM_DATE - Time Zone: Unspecified and SERVICE_START_DATE - Time Zone: Unspecified |
Data Aggregation Pharmacy Claim Load
| PatientId |
|
||||
|
If PAT_ID is NULL then IDENT_BUNDLE_ID Otherwise PAT_ID |
|||||
| PatientIdType |
|
||||
|
If PAT_ID is NULL then "EpicExternalIDBundleID" Otherwise "EpicPatientId" |
|||||
| StartDate |
|
||||
Externally Adjudicated Medical Claim Load
| PatientId |
|
||||||
|
If PAT_ID is NULL then IDENT_BUNDLE_ID Otherwise PAT_ID |
|||||||
| PatientIdType |
|
||||||
|
If PAT_ID is NULL then "EpicExternalIDBundleID" Otherwise "EpicPatientId" |
|||||||
| StartDate |
|
||||||
|
Minimum of STMT_COV_FROM_DATE - Time Zone: Unspecified and SERVICE_START_DATE - Time Zone: Unspecified |
Externally Adjudicated Pharmacy Claim Load
| PatientId |
|
||||
|
If PAT_ID is NULL then IDENT_BUNDLE_ID Otherwise PAT_ID |
|||||
| PatientIdType |
|
||||
|
If PAT_ID is NULL then "EpicExternalIDBundleID" Otherwise "EpicPatientId" |
|||||
| StartDate |
|
||||
Payer System Medical Claim Load
| PatientId |
|
||||
|
If PAT_ID is NULL then IDENT_BUNDLE_ID Otherwise PAT_ID |
|||||
| PatientIdType |
|
||||
|
If PAT_ID is NULL then "EpicExternalIDBundleID" Otherwise "EpicPatientId" |
|||||
| StartDate |
|
||||
|
Minimum of STMT_COV_FROM_DATE - Time Zone: Unspecified and SERVICE_START_DATE - Time Zone: Unspecified |
Payer System Pharmacy Claim Load
| PatientId |
|
||||
|
If PAT_ID is NULL then IDENT_BUNDLE_ID Otherwise PAT_ID |
|||||
| PatientIdType |
|
||||
|
If PAT_ID is NULL then "EpicExternalIDBundleID" Otherwise "EpicPatientId" |
|||||
| StartDate |
|
||||
Received Claim Load
| PatientId |
|
||||
|
If PAT_ID is NULL then IDENT_BUNDLE_ID Otherwise PAT_ID |
|||||
| PatientIdType |
|
||||
|
If PAT_ID is NULL then "EpicExternalIDBundleID" Otherwise "EpicPatientId" |
|||||
| StartDate |
|
||||
|
Minimum of STMT_COV_FROM_DATE - Time Zone: Unspecified and SERVICE_START_DATE - Time Zone: Unspecified |
Received Pharmacy Claim Load
| PatientId |
|
||||
|
If PAT_ID is NULL then IDENT_BUNDLE_ID Otherwise PAT_ID |
|||||
| PatientIdType |
|
||||
|
If PAT_ID is NULL then "EpicExternalIDBundleID" Otherwise "EpicPatientId" |
|||||
| StartDate |
|
||||
PatientDurableKey
: integerPatient associated with the claim
Properties
- Data type
- integer
- SQL Server data type
- bigint
- Allows null
- No
- Default value
- -1
- Delete value
- -3
Data Lineage for Each Package
CMS ACO Part A Files Load
| PatientId |
|
||
|
The preferred id will be used from "BENE_HIC_NUM" if populated; otherwise the fallback id will be used from "MBI" |
|||
| PatientIdType |
The preferred id type "EpicPatientHicn" if the column "BENE_HIC_NUM" is populated Otherwise "EpicPatientMbi" will be used with the value from the column "MBI" |
CMS ACO Part B DME File Load
| PatientId |
|
||
|
The preferred id will be used from "BENE_HIC_NUM" if populated; otherwise the fallback id will be used from "MBI" |
|||
| PatientIdType |
The preferred id type "EpicPatientHicn" if the column "BENE_HIC_NUM" is populated Otherwise "EpicPatientMbi" will be used with the value from the column "MBI" |
CMS ACO Part B Physicians File Load
| PatientId |
|
||
|
The preferred id will be used from "BENE_HIC_NUM" if populated; otherwise the fallback id will be used from "MBI" |
|||
| PatientIdType |
The preferred id type "EpicPatientHicn" if the column "BENE_HIC_NUM" is populated Otherwise "EpicPatientMbi" will be used with the value from the column "MBI" |
CMS ACO Part D Prescription Drug File Load
| PatientId |
|
||
| PatientIdType |
"EpicPatientHicn" |
CMS CJR DME Claim Load
| PatientId |
|
||
| PatientIdType |
IdrBeneficiaryKey |
CMS CJR Home Health Claim Load
| PatientId |
|
||
| PatientIdType |
IdrBeneficiaryKey |
CMS CJR Hospice Claim Load
| PatientId |
|
||
| PatientIdType |
IdrBeneficiaryKey |
CMS CJR Inpatient Claim Load
| PatientId |
|
||
| PatientIdType |
IdrBeneficiaryKey |
CMS CJR Outpatient Claim Load
| PatientId |
|
||
| PatientIdType |
IdrBeneficiaryKey |
CMS CJR Part B Claim Load
| PatientId |
|
||
| PatientIdType |
IdrBeneficiaryKey |
CMS CJR Skilled Nursing Facility Claim Load
| PatientId |
|
||
| PatientIdType |
IdrBeneficiaryKey |
Data Aggregation Medical Claim Load
| PatientId |
|
||||
|
If PAT_ID is NULL then IDENT_BUNDLE_ID Otherwise PAT_ID |
|||||
| PatientIdType |
|
||||
|
If PAT_ID is NULL then "EpicExternalIDBundleID" Otherwise "EpicPatientId" |
Data Aggregation Pharmacy Claim Load
| PatientId |
|
||||
|
If PAT_ID is NULL then IDENT_BUNDLE_ID Otherwise PAT_ID |
|||||
| PatientIdType |
|
||||
|
If PAT_ID is NULL then "EpicExternalIDBundleID" Otherwise "EpicPatientId" |
Externally Adjudicated Medical Claim Load
| PatientId |
|
||||||
|
If PAT_ID is NULL then IDENT_BUNDLE_ID Otherwise PAT_ID |
|||||||
| PatientIdType |
|
||||||
|
If PAT_ID is NULL then "EpicExternalIDBundleID" Otherwise "EpicPatientId" |
Externally Adjudicated Pharmacy Claim Load
| PatientId |
|
||||
|
If PAT_ID is NULL then IDENT_BUNDLE_ID Otherwise PAT_ID |
|||||
| PatientIdType |
|
||||
|
If PAT_ID is NULL then "EpicExternalIDBundleID" Otherwise "EpicPatientId" |
Payer System Medical Claim Load
| PatientId |
|
||||
|
If PAT_ID is NULL then IDENT_BUNDLE_ID Otherwise PAT_ID |
|||||
| PatientIdType |
|
||||
|
If PAT_ID is NULL then "EpicExternalIDBundleID" Otherwise "EpicPatientId" |
Payer System Pharmacy Claim Load
| PatientId |
|
||||
|
If PAT_ID is NULL then IDENT_BUNDLE_ID Otherwise PAT_ID |
|||||
| PatientIdType |
|
||||
|
If PAT_ID is NULL then "EpicExternalIDBundleID" Otherwise "EpicPatientId" |
Received Claim Load
| PatientId |
|
||||
|
If PAT_ID is NULL then IDENT_BUNDLE_ID Otherwise PAT_ID |
|||||
| PatientIdType |
|
||||
|
If PAT_ID is NULL then "EpicExternalIDBundleID" Otherwise "EpicPatientId" |
Received Pharmacy Claim Load
| PatientId |
|
||||
|
If PAT_ID is NULL then IDENT_BUNDLE_ID Otherwise PAT_ID |
|||||
| PatientIdType |
|
||||
|
If PAT_ID is NULL then "EpicExternalIDBundleID" Otherwise "EpicPatientId" |
PatientSourceDataDurableKey
: integerPatient associated with the claim
Properties
- Data type
- integer
- SQL Server data type
- bigint
- Allows null
- No
- Default value
- -1
- Delete value
- -3
Data Lineage for Each Package
CMS ACO Part A Files Load
| PatientId |
|
||
|
The preferred id will be used from "BENE_HIC_NUM" if populated; otherwise the fallback id will be used from "MBI" |
|||
| PatientIdType |
The preferred id type "EpicPatientHicn" if the column "BENE_HIC_NUM" is populated Otherwise "EpicPatientMbi" will be used with the value from the column "MBI" |
||
| PatientSourceName |
NULL (use source of the package) |
CMS ACO Part B DME File Load
| PatientId |
|
||
|
The preferred id will be used from "BENE_HIC_NUM" if populated; otherwise the fallback id will be used from "MBI" |
|||
| PatientIdType |
The preferred id type "EpicPatientHicn" if the column "BENE_HIC_NUM" is populated Otherwise "EpicPatientMbi" will be used with the value from the column "MBI" |
||
| PatientSourceName |
NULL (use source of the package) |
CMS ACO Part B Physicians File Load
| PatientId |
|
||
|
The preferred id will be used from "BENE_HIC_NUM" if populated; otherwise the fallback id will be used from "MBI" |
|||
| PatientIdType |
The preferred id type "EpicPatientHicn" if the column "BENE_HIC_NUM" is populated Otherwise "EpicPatientMbi" will be used with the value from the column "MBI" |
||
| PatientSourceName |
NULL (use source of the package) |
CMS ACO Part D Prescription Drug File Load
| PatientId |
|
||
| PatientIdType |
"EpicPatientHicn" |
||
| PatientSourceName |
NULL (use source of the package) |
CMS CJR DME Claim Load
| PatientId |
|
||
| PatientIdType |
IdrBeneficiaryKey |
||
| PatientSourceName |
NULL (use source of the package) |
CMS CJR Home Health Claim Load
| PatientId |
|
||
| PatientIdType |
IdrBeneficiaryKey |
||
| PatientSourceName |
NULL (use source of the package) |
CMS CJR Hospice Claim Load
| PatientId |
|
||
| PatientIdType |
IdrBeneficiaryKey |
||
| PatientSourceName |
NULL (use source of the package) |
CMS CJR Inpatient Claim Load
| PatientId |
|
||
| PatientIdType |
IdrBeneficiaryKey |
||
| PatientSourceName |
NULL (use source of the package) |
CMS CJR Outpatient Claim Load
| PatientId |
|
||
| PatientIdType |
IdrBeneficiaryKey |
||
| PatientSourceName |
NULL (use source of the package) |
CMS CJR Part B Claim Load
| PatientId |
|
||
| PatientIdType |
IdrBeneficiaryKey |
||
| PatientSourceName |
NULL (use source of the package) |
CMS CJR Skilled Nursing Facility Claim Load
| PatientId |
|
||
| PatientIdType |
IdrBeneficiaryKey |
||
| PatientSourceName |
NULL (use source of the package) |
Data Aggregation Medical Claim Load
| PatientId |
|
||||
|
If PAT_ID is NULL then IDENT_BUNDLE_ID Otherwise PAT_ID |
|||||
| PatientIdType |
|
||||
|
If PAT_ID is NULL then "EpicExternalIDBundleID" Otherwise "EpicPatientId" |
|||||
| PatientSourceName |
NULL (use source of the package) |
Data Aggregation Pharmacy Claim Load
| PatientId |
|
||||
|
If PAT_ID is NULL then IDENT_BUNDLE_ID Otherwise PAT_ID |
|||||
| PatientIdType |
|
||||
|
If PAT_ID is NULL then "EpicExternalIDBundleID" Otherwise "EpicPatientId" |
|||||
| PatientSourceName |
Externally Adjudicated Medical Claim Load
| PatientId |
|
||||||
|
If PAT_ID is NULL then IDENT_BUNDLE_ID Otherwise PAT_ID |
|||||||
| PatientIdType |
|
||||||
|
If PAT_ID is NULL then "EpicExternalIDBundleID" Otherwise "EpicPatientId" |
|||||||
| PatientSourceName |
NULL (use source of the package) |
Externally Adjudicated Pharmacy Claim Load
| PatientId |
|
||||
|
If PAT_ID is NULL then IDENT_BUNDLE_ID Otherwise PAT_ID |
|||||
| PatientIdType |
|
||||
|
If PAT_ID is NULL then "EpicExternalIDBundleID" Otherwise "EpicPatientId" |
|||||
| PatientSourceName |
Payer System Medical Claim Load
| PatientId |
|
||||
|
If PAT_ID is NULL then IDENT_BUNDLE_ID Otherwise PAT_ID |
|||||
| PatientIdType |
|
||||
|
If PAT_ID is NULL then "EpicExternalIDBundleID" Otherwise "EpicPatientId" |
|||||
| PatientSourceName |
NULL (use source of the package) |
Payer System Pharmacy Claim Load
| PatientId |
|
||||
|
If PAT_ID is NULL then IDENT_BUNDLE_ID Otherwise PAT_ID |
|||||
| PatientIdType |
|
||||
|
If PAT_ID is NULL then "EpicExternalIDBundleID" Otherwise "EpicPatientId" |
|||||
| PatientSourceName |
Received Claim Load
| PatientId |
|
||||
|
If PAT_ID is NULL then IDENT_BUNDLE_ID Otherwise PAT_ID |
|||||
| PatientIdType |
|
||||
|
If PAT_ID is NULL then "EpicExternalIDBundleID" Otherwise "EpicPatientId" |
|||||
| PatientSourceName |
NULL (use source of the package) |
Received Pharmacy Claim Load
| PatientId |
|
||||
|
If PAT_ID is NULL then IDENT_BUNDLE_ID Otherwise PAT_ID |
|||||
| PatientIdType |
|
||||
|
If PAT_ID is NULL then "EpicExternalIDBundleID" Otherwise "EpicPatientId" |
|||||
| PatientSourceName |
PrimaryCoverageKey
: integerPrimary coverage associated with the claim
Properties
- Data type
- integer
- SQL Server data type
- bigint
- Allows null
- No
- Default value
- -1
- Delete value
- -3
Data Lineage for Each Package
CMS ACO Part A Files Load
| PrimaryCoverageId |
|
||||
|
If CLM_PRMRY_PYR_CD = NULL-Medicare is primary payer, C-Conditional payment by Medicare; future reimbursement expected, M-Override Code: EGHP services involved, N-Override Code: non-EGHP services involved, Y-Other secondary payer investigation shows Medicare as primary payer, or Z-Medicare is primary payer then CmsPayorEpicId component configuration for ReceivedClaimFact or payer configured in the Chronicles interface Otherwise NULL |
|||||
| PrimaryCoverageIdType |
|
||||
|
If CLM_PRMRY_PYR_CD = NULL-Medicare is primary payer, C-Conditional payment by Medicare; future reimbursement expected, M-Override Code: EGHP services involved, N-Override Code: non-EGHP services involved, Y-Other secondary payer investigation shows Medicare as primary payer, or Z-Medicare is primary payer then "EpicPayorId" Otherwise "NotApplicable" |
CMS ACO Part B DME File Load
| PrimaryCoverageId |
|
||||
|
If CLM_PRMRY_PYR_CD = NULL-Medicare is primary payer, C-Conditional payment by Medicare; future reimbursement expected, M-Override Code: EGHP services involved, N-Override Code: non-EGHP services involved, Y-Other secondary payer investigation shows Medicare as primary payer, or Z-Medicare is primary payer then CmsPayorEpicId component configuration for ReceivedClaimFact or payer configured in the Chronicles interface Otherwise NULL |
|||||
| PrimaryCoverageIdType |
|
||||
|
If CLM_PRMRY_PYR_CD = NULL-Medicare is primary payer, C-Conditional payment by Medicare; future reimbursement expected, M-Override Code: EGHP services involved, N-Override Code: non-EGHP services involved, Y-Other secondary payer investigation shows Medicare as primary payer, or Z-Medicare is primary payer then "EpicPayorId" Otherwise "NotApplicable" |
CMS ACO Part B Physicians File Load
| PrimaryCoverageId |
|
||||
|
If CLM_PRMRY_PYR_CD = NULL-Medicare is primary payer, C-Conditional payment by Medicare; future reimbursement expected, M-Override Code: EGHP services involved, N-Override Code: non-EGHP services involved, Y-Other secondary payer investigation shows Medicare as primary payer, or Z-Medicare is primary payer then CmsPayorEpicId component configuration for ReceivedClaimFact or payer configured in the Chronicles interface Otherwise NULL |
|||||
| PrimaryCoverageIdType |
|
||||
|
If CLM_PRMRY_PYR_CD = NULL-Medicare is primary payer, C-Conditional payment by Medicare; future reimbursement expected, M-Override Code: EGHP services involved, N-Override Code: non-EGHP services involved, Y-Other secondary payer investigation shows Medicare as primary payer, or Z-Medicare is primary payer then "EpicPayorId" Otherwise "NotApplicable" |
CMS ACO Part D Prescription Drug File Load
| PrimaryCoverageId |
|
||
|
CmsPayorEpicId component configuration for ReceivedClaimFact or payer configured in the Chronicles interface |
|||
| PrimaryCoverageIdType |
"EpicPayorId" |
CMS CJR DME Claim Load
| PrimaryCoverageId |
|
||
|
If PRPAYAMT is NULL or PRPAYAMT = 0 then CmsPayorEpicId Otherwise NotApplicable |
|||
| PrimaryCoverageIdType |
|
||
|
If PRPAYAMT is NULL or PRPAYAMT = 0 then EpicPayorId Otherwise NotApplicable |
CMS CJR Home Health Claim Load
| PrimaryCoverageId |
|
||
|
If PRPAYCD = NULL-Medicare is primary payer, C-Conditional payment by Medicare; future reimbursement expected, M-Override Code: EGHP services involved, N-Override Code: non-EGHP services involved, Y-Other secondary payer investigation shows Medicare as primary payer, or Z-Medicare is primary payer then CmsPayorEpicId Otherwise NULL |
|||
| PrimaryCoverageIdType |
|
||
|
If PRPAYCD = NULL-Medicare is primary payer, C-Conditional payment by Medicare; future reimbursement expected, M-Override Code: EGHP services involved, N-Override Code: non-EGHP services involved, Y-Other secondary payer investigation shows Medicare as primary payer, or Z-Medicare is primary payer then EpicPayorId Otherwise NotApplicable |
CMS CJR Hospice Claim Load
| PrimaryCoverageId |
|
||
|
If PRPAYCD = NULL-Medicare is primary payer, C-Conditional payment by Medicare; future reimbursement expected, M-Override Code: EGHP services involved, N-Override Code: non-EGHP services involved, Y-Other secondary payer investigation shows Medicare as primary payer, or Z-Medicare is primary payer then CmsPayorEpicId Otherwise NULL |
|||
| PrimaryCoverageIdType |
|
||
|
If PRPAYCD = NULL-Medicare is primary payer, C-Conditional payment by Medicare; future reimbursement expected, M-Override Code: EGHP services involved, N-Override Code: non-EGHP services involved, Y-Other secondary payer investigation shows Medicare as primary payer, or Z-Medicare is primary payer then EpicPayorId Otherwise NotApplicable |
CMS CJR Inpatient Claim Load
| PrimaryCoverageId |
|
||
|
If PRPAYCD = NULL-Medicare is primary payer, C-Conditional payment by Medicare; future reimbursement expected, M-Override Code: EGHP services involved, N-Override Code: non-EGHP services involved, Y-Other secondary payer investigation shows Medicare as primary payer, or Z-Medicare is primary payer then CmsPayorEpicId Otherwise NULL |
|||
| PrimaryCoverageIdType |
|
||
|
If PRPAYCD = NULL-Medicare is primary payer, C-Conditional payment by Medicare; future reimbursement expected, M-Override Code: EGHP services involved, N-Override Code: non-EGHP services involved, Y-Other secondary payer investigation shows Medicare as primary payer, or Z-Medicare is primary payer then EpicPayorId Otherwise NotApplicable |
CMS CJR Outpatient Claim Load
| PrimaryCoverageId |
|
||
|
If PRPAYCD = NULL-Medicare is primary payer, C-Conditional payment by Medicare; future reimbursement expected, M-Override Code: EGHP services involved, N-Override Code: non-EGHP services involved, Y-Other secondary payer investigation shows Medicare as primary payer, or Z-Medicare is primary payer then CmsPayorEpicId Otherwise NULL |
|||
| PrimaryCoverageIdType |
|
||
|
If PRPAYCD = NULL-Medicare is primary payer, C-Conditional payment by Medicare; future reimbursement expected, M-Override Code: EGHP services involved, N-Override Code: non-EGHP services involved, Y-Other secondary payer investigation shows Medicare as primary payer, or Z-Medicare is primary payer then EpicPayorId Otherwise NotApplicable |
CMS CJR Part B Claim Load
| PrimaryCoverageId |
|
||
|
If PRPAYAMT is NULL or PRPAYAMT = 0 then CmsPayorEpicId Otherwise NotApplicable |
|||
| PrimaryCoverageIdType |
|
||
|
If PRPAYAMT is NULL or PRPAYAMT = 0 then EpicPayorId Otherwise NotApplicable |
CMS CJR Skilled Nursing Facility Claim Load
| PrimaryCoverageId |
|
||
|
If PRPAYCD = NULL-Medicare is primary payer, C-Conditional payment by Medicare; future reimbursement expected, M-Override Code: EGHP services involved, N-Override Code: non-EGHP services involved, Y-Other secondary payer investigation shows Medicare as primary payer, or Z-Medicare is primary payer then CmsPayorEpicId Otherwise NULL |
|||
| PrimaryCoverageIdType |
|
||
|
If PRPAYCD = NULL-Medicare is primary payer, C-Conditional payment by Medicare; future reimbursement expected, M-Override Code: EGHP services involved, N-Override Code: non-EGHP services involved, Y-Other secondary payer investigation shows Medicare as primary payer, or Z-Medicare is primary payer then EpicPayorId Otherwise NotApplicable |
Data Aggregation Medical Claim Load
| PrimaryCoverageId |
|
||
| PrimaryCoverageIdType |
|
||
|
If PRIM_PAYOR_ID is not NULL then "EpicPayorId" Otherwise "NotApplicable" |
Data Aggregation Pharmacy Claim Load
| PrimaryCoverageId |
|
||
| PrimaryCoverageIdType |
|
||
|
If PRIM_PAYOR_ID is not NULL then "EpicPayorId" Otherwise "NotApplicable" |
Externally Adjudicated Medical Claim Load
| PrimaryCoverageId |
|
||
|
AP_CLAIM_3.PRIM_PAYOR_ID |
|||
| PrimaryCoverageIdType |
|
||
|
If AP_CLAIM_3.PRIM_PAYOR_ID is not NULL then "EpicPayorId" Otherwise "NotApplicable" |
Externally Adjudicated Pharmacy Claim Load
| PrimaryCoverageId |
|
||
|
AP_CLM_RX_2.PRIM_PAYOR_ID |
|||
| PrimaryCoverageIdType |
|
||
|
If AP_CLM_RX_2.PRIM_PAYOR_ID is not NULL then "EpicPayorId" Otherwise "NotApplicable"' |
Payer System Medical Claim Load
| PrimaryCoverageId |
|
||
| PrimaryCoverageIdType |
|
||
|
If PRIM_PAYOR_ID is not NULL then "EpicPayorId" Otherwise "NotApplicable" |
Payer System Pharmacy Claim Load
| PrimaryCoverageId |
|
||
| PrimaryCoverageIdType |
|
||
|
If PRIM_PAYOR_ID is not NULL then "EpicPayorId" Otherwise "NotApplicable" |
Received Claim Load
| PrimaryCoverageId |
|
||
| PrimaryCoverageIdType |
"EpicCoverageId" |
Received Pharmacy Claim Load
| PrimaryCoverageId |
|
||
| PrimaryCoverageIdType |
"EpicCoverageId" |
SecondCoverageKey
: integerSecond coverage associated with the claim
Properties
- Data type
- integer
- SQL Server data type
- bigint
- Allows null
- No
- Default value
- -1
- Delete value
- -3
Data Lineage for Each Package
CMS ACO Part A Files Load
| SecondCoverageId |
|
||||
|
If CLM_PRMRY_PYR_CD = NULL-Medicare is primary payer, C-Conditional payment by Medicare; future reimbursement expected, M-Override Code: EGHP services involved, N-Override Code: non-EGHP services involved, Y-Other secondary payer investigation shows Medicare as primary payer, or Z-Medicare is primary payer then NULL Otherwise CmsPayorEpicId component configuration for ReceivedClaimFact or payer configured in the Chronicles interface |
|||||
| SecondCoverageIdType |
|
||||
|
If CLM_PRMRY_PYR_CD = NULL-Medicare is primary payer, C-Conditional payment by Medicare; future reimbursement expected, M-Override Code: EGHP services involved, N-Override Code: non-EGHP services involved, Y-Other secondary payer investigation shows Medicare as primary payer, or Z-Medicare is primary payer then "NotApplicable" Otherwise "EpicPayorId" |
CMS ACO Part B DME File Load
| SecondCoverageId |
|
||||
|
If CLM_PRMRY_PYR_CD = NULL-Medicare is primary payer, C-Conditional payment by Medicare; future reimbursement expected, M-Override Code: EGHP services involved, N-Override Code: non-EGHP services involved, Y-Other secondary payer investigation shows Medicare as primary payer, or Z-Medicare is primary payer then NULL Otherwise CmsPayorEpicId component configuration for ReceivedClaimFact or payer configured in the Chronicles interface |
|||||
| SecondCoverageIdType |
|
||||
|
If CLM_PRMRY_PYR_CD = NULL-Medicare is primary payer, C-Conditional payment by Medicare; future reimbursement expected, M-Override Code: EGHP services involved, N-Override Code: non-EGHP services involved, Y-Other secondary payer investigation shows Medicare as primary payer, or Z-Medicare is primary payer then "NotApplicable" Otherwise "EpicPayorId" |
CMS ACO Part B Physicians File Load
| SecondCoverageId |
|
||||
|
If CLM_PRMRY_PYR_CD = NULL-Medicare is primary payer, C-Conditional payment by Medicare; future reimbursement expected, M-Override Code: EGHP services involved, N-Override Code: non-EGHP services involved, Y-Other secondary payer investigation shows Medicare as primary payer, or Z-Medicare is primary payer then NULL Otherwise CmsPayorEpicId component configuration for ReceivedClaimFact or payer configured in the Chronicles interface |
|||||
| SecondCoverageIdType |
|
||||
|
If CLM_PRMRY_PYR_CD = NULL-Medicare is primary payer, C-Conditional payment by Medicare; future reimbursement expected, M-Override Code: EGHP services involved, N-Override Code: non-EGHP services involved, Y-Other secondary payer investigation shows Medicare as primary payer, or Z-Medicare is primary payer then "NotApplicable" Otherwise "EpicPayorId" |
CMS ACO Part D Prescription Drug File Load
| SecondCoverageId |
NULL |
| SecondCoverageIdType |
"NotApplicable" |
CMS CJR DME Claim Load
| SecondCoverageId |
|
||
|
If PRPAYAMT is NULL or PRPAYAMT = 0 then NULL Otherwise CmsPayorEpicId |
|||
| SecondCoverageIdType |
|
||
|
If PRPAYAMT is NULL or PRPAYAMT = 0 then NotApplicable Otherwise EpicPayorId |
CMS CJR Home Health Claim Load
| SecondCoverageId |
|
||
|
If PRPAYCD = NULL-Medicare is primary payer, C-Conditional payment by Medicare; future reimbursement expected, M-Override Code: EGHP services involved, N-Override Code: non-EGHP services involved, Y-Other secondary payer investigation shows Medicare as primary payer, or Z-Medicare is primary payer then NULL Otherwise CmsPayorEpicId |
|||
| SecondCoverageIdType |
|
||
|
If PRPAYCD = NULL-Medicare is primary payer, C-Conditional payment by Medicare; future reimbursement expected, M-Override Code: EGHP services involved, N-Override Code: non-EGHP services involved, Y-Other secondary payer investigation shows Medicare as primary payer, or Z-Medicare is primary payer then NotApplicable Otherwise EpicPayorId |
CMS CJR Hospice Claim Load
| SecondCoverageId |
|
||
|
If PRPAYCD = NULL-Medicare is primary payer, C-Conditional payment by Medicare; future reimbursement expected, M-Override Code: EGHP services involved, N-Override Code: non-EGHP services involved, Y-Other secondary payer investigation shows Medicare as primary payer, or Z-Medicare is primary payer then NULL Otherwise CmsPayorEpicId |
|||
| SecondCoverageIdType |
|
||
|
If PRPAYCD = NULL-Medicare is primary payer, C-Conditional payment by Medicare; future reimbursement expected, M-Override Code: EGHP services involved, N-Override Code: non-EGHP services involved, Y-Other secondary payer investigation shows Medicare as primary payer, or Z-Medicare is primary payer then NotApplicable Otherwise EpicPayorId |
CMS CJR Inpatient Claim Load
| SecondCoverageId |
|
||
|
If PRPAYCD = NULL-Medicare is primary payer, C-Conditional payment by Medicare; future reimbursement expected, M-Override Code: EGHP services involved, N-Override Code: non-EGHP services involved, Y-Other secondary payer investigation shows Medicare as primary payer, or Z-Medicare is primary payer then NULL Otherwise CmsPayorEpicId |
|||
| SecondCoverageIdType |
|
||
|
If PRPAYCD = NULL-Medicare is primary payer, C-Conditional payment by Medicare; future reimbursement expected, M-Override Code: EGHP services involved, N-Override Code: non-EGHP services involved, Y-Other secondary payer investigation shows Medicare as primary payer, or Z-Medicare is primary payer then NotApplicable Otherwise EpicPayorId |
CMS CJR Outpatient Claim Load
| SecondCoverageId |
|
||
|
If PRPAYCD = NULL-Medicare is primary payer, C-Conditional payment by Medicare; future reimbursement expected, M-Override Code: EGHP services involved, N-Override Code: non-EGHP services involved, Y-Other secondary payer investigation shows Medicare as primary payer, or Z-Medicare is primary payer then NULL Otherwise CmsPayorEpicId |
|||
| SecondCoverageIdType |
|
||
|
If PRPAYCD = NULL-Medicare is primary payer, C-Conditional payment by Medicare; future reimbursement expected, M-Override Code: EGHP services involved, N-Override Code: non-EGHP services involved, Y-Other secondary payer investigation shows Medicare as primary payer, or Z-Medicare is primary payer then NotApplicable Otherwise EpicPayorId |
CMS CJR Part B Claim Load
| SecondCoverageId |
|
||
|
If PRPAYAMT is NULL or PRPAYAMT = 0 then NULL Otherwise CmsPayorEpicId |
|||
| SecondCoverageIdType |
|
||
|
If PRPAYAMT is NULL or PRPAYAMT = 0 then NotApplicable Otherwise EpicPayorId |
CMS CJR Skilled Nursing Facility Claim Load
| SecondCoverageId |
|
||
|
If PRPAYCD = NULL-Medicare is primary payer, C-Conditional payment by Medicare; future reimbursement expected, M-Override Code: EGHP services involved, N-Override Code: non-EGHP services involved, Y-Other secondary payer investigation shows Medicare as primary payer, or Z-Medicare is primary payer then NULL Otherwise CmsPayorEpicId |
|||
| SecondCoverageIdType |
|
||
|
If PRPAYCD = NULL-Medicare is primary payer, C-Conditional payment by Medicare; future reimbursement expected, M-Override Code: EGHP services involved, N-Override Code: non-EGHP services involved, Y-Other secondary payer investigation shows Medicare as primary payer, or Z-Medicare is primary payer then NotApplicable Otherwise EpicPayorId |
Data Aggregation Medical Claim Load
| SecondCoverageId |
NULL |
| SecondCoverageIdType |
"NotApplicable" |
Data Aggregation Pharmacy Claim Load
| SecondCoverageId | |
| SecondCoverageIdType |
"Unspecified" |
Externally Adjudicated Medical Claim Load
| SecondCoverageId |
NULL |
| SecondCoverageIdType |
"NotApplicable" |
Externally Adjudicated Pharmacy Claim Load
| SecondCoverageId | |
| SecondCoverageIdType |
"Unspecified" |
Payer System Medical Claim Load
| SecondCoverageId |
NULL |
| SecondCoverageIdType |
"NotApplicable" |
Payer System Pharmacy Claim Load
| SecondCoverageId | |
| SecondCoverageIdType |
"Unspecified" |
Received Claim Load
| SecondCoverageId |
NULL |
| SecondCoverageIdType |
"NotApplicable" |
Received Pharmacy Claim Load
| SecondCoverageId | |
| SecondCoverageIdType |
"Unspecified" |
ThirdCoverageKey
: integerThird coverage associated with the claim
Properties
- Data type
- integer
- SQL Server data type
- bigint
- Allows null
- No
- Default value
- -1
- Delete value
- -3
Data Lineage for Each Package
CMS ACO Part A Files Load
| ThirdCoverageId |
NULL |
| ThirdCoverageIdType |
"NotApplicable" |
CMS ACO Part B DME File Load
| ThirdCoverageId |
NULL |
| ThirdCoverageIdType |
"NotApplicable" |
CMS ACO Part B Physicians File Load
| ThirdCoverageId |
NULL |
| ThirdCoverageIdType |
"NotApplicable" |
CMS ACO Part D Prescription Drug File Load
| ThirdCoverageId |
NULL |
| ThirdCoverageIdType |
"NotApplicable" |
CMS CJR DME Claim Load
| ThirdCoverageId |
NULL |
| ThirdCoverageIdType |
NotApplicable |
CMS CJR Home Health Claim Load
| ThirdCoverageId |
NULL |
| ThirdCoverageIdType |
NotApplicable |
CMS CJR Hospice Claim Load
| ThirdCoverageId |
NULL |
| ThirdCoverageIdType |
NotApplicable |
CMS CJR Inpatient Claim Load
| ThirdCoverageId |
NULL |
| ThirdCoverageIdType |
NotApplicable |
CMS CJR Outpatient Claim Load
| ThirdCoverageId |
NULL |
| ThirdCoverageIdType |
NotApplicable |
CMS CJR Part B Claim Load
| ThirdCoverageId |
NULL |
| ThirdCoverageIdType |
NotApplicable |
CMS CJR Skilled Nursing Facility Claim Load
| ThirdCoverageId |
NULL |
| ThirdCoverageIdType |
NotApplicable |
Data Aggregation Medical Claim Load
| ThirdCoverageId |
NULL |
| ThirdCoverageIdType |
"NotApplicable" |
Data Aggregation Pharmacy Claim Load
| ThirdCoverageId | |
| ThirdCoverageIdType |
"Unspecified" |
Externally Adjudicated Medical Claim Load
| ThirdCoverageId |
NULL |
| ThirdCoverageIdType |
"NotApplicable" |
Externally Adjudicated Pharmacy Claim Load
| ThirdCoverageId | |
| ThirdCoverageIdType |
"Unspecified" |
Payer System Medical Claim Load
| ThirdCoverageId |
NULL |
| ThirdCoverageIdType |
"NotApplicable" |
Payer System Pharmacy Claim Load
| ThirdCoverageId | |
| ThirdCoverageIdType |
"Unspecified" |
Received Claim Load
| ThirdCoverageId |
NULL |
| ThirdCoverageIdType |
"NotApplicable" |
Received Pharmacy Claim Load
| ThirdCoverageId | |
| ThirdCoverageIdType |
"Unspecified" |
AttributedRegionKey
: integerThe region associated with the primary coverage of the member on the claim
Properties
- Data type
- integer
- SQL Server data type
- bigint
- Allows null
- No
- Default value
- -1
- Delete value
- -3
Data Lineage for Each Package
CMS ACO Part A Files Load
| AttributedRegionId |
NULL |
| AttributedRegionIdType |
"Unspecified" |
CMS ACO Part B DME File Load
| AttributedRegionId |
NULL |
| AttributedRegionIdType |
"Unspecified" |
CMS ACO Part B Physicians File Load
| AttributedRegionId |
NULL |
| AttributedRegionIdType |
"Unspecified" |
CMS ACO Part D Prescription Drug File Load
| AttributedRegionId |
NULL |
| AttributedRegionIdType |
"Unspecified" |
CMS CJR DME Claim Load
| AttributedRegionId |
NULL |
| AttributedRegionIdType |
CMS CJR Home Health Claim Load
| AttributedRegionId |
NULL |
| AttributedRegionIdType |
CMS CJR Hospice Claim Load
| AttributedRegionId |
NULL |
| AttributedRegionIdType |
CMS CJR Inpatient Claim Load
| AttributedRegionId |
NULL |
| AttributedRegionIdType |
CMS CJR Outpatient Claim Load
| AttributedRegionId |
NULL |
| AttributedRegionIdType |
CMS CJR Part B Claim Load
| AttributedRegionId |
NULL |
| AttributedRegionIdType |
CMS CJR Skilled Nursing Facility Claim Load
| AttributedRegionId |
NULL |
| AttributedRegionIdType |
Data Aggregation Medical Claim Load
| AttributedRegionId |
NULL |
| AttributedRegionIdType |
"Unspecified" |
Data Aggregation Pharmacy Claim Load
| AttributedRegionId |
NULL |
| AttributedRegionIdType |
"Unspecified" |
Externally Adjudicated Medical Claim Load
| AttributedRegionId |
|
||
| AttributedRegionIdType |
"EpicFacilityProfileId" |
Externally Adjudicated Pharmacy Claim Load
| AttributedRegionId |
|
||
| AttributedRegionIdType |
Received Claim Load
| AttributedRegionId |
|
||
| AttributedRegionIdType |
Received Pharmacy Claim Load
| AttributedRegionId |
|
||
| AttributedRegionIdType |
AttributedMedicalGroupKey
: integerThe medical group associated with the primary coverage of the member on the claim
Properties
- Data type
- integer
- SQL Server data type
- bigint
- Allows null
- No
- Default value
- -1
- Delete value
- -3
Data Lineage for Each Package
CMS ACO Part A Files Load
| AttributedMedicalGroupId |
NULL |
| AttributedMedicalGroupIdType |
"Unspecified" |
CMS ACO Part B DME File Load
| AttributedMedicalGroupId |
NULL |
| AttributedMedicalGroupIdType |
"Unspecified" |
CMS ACO Part B Physicians File Load
| AttributedMedicalGroupId |
NULL |
| AttributedMedicalGroupIdType |
"Unspecified" |
CMS ACO Part D Prescription Drug File Load
| AttributedMedicalGroupId |
NULL |
| AttributedMedicalGroupIdType |
"Unspecified" |
CMS CJR DME Claim Load
| AttributedMedicalGroupId |
NULL |
| AttributedMedicalGroupIdType |
CMS CJR Home Health Claim Load
| AttributedMedicalGroupId |
NULL |
| AttributedMedicalGroupIdType |
CMS CJR Hospice Claim Load
| AttributedMedicalGroupId |
NULL |
| AttributedMedicalGroupIdType |
CMS CJR Inpatient Claim Load
| AttributedMedicalGroupId |
NULL |
| AttributedMedicalGroupIdType |
CMS CJR Outpatient Claim Load
| AttributedMedicalGroupId |
NULL |
| AttributedMedicalGroupIdType |
CMS CJR Part B Claim Load
| AttributedMedicalGroupId |
NULL |
| AttributedMedicalGroupIdType |
CMS CJR Skilled Nursing Facility Claim Load
| AttributedMedicalGroupId |
NULL |
| AttributedMedicalGroupIdType |
Data Aggregation Medical Claim Load
| AttributedMedicalGroupId |
NULL |
| AttributedMedicalGroupIdType |
"Unspecified" |
Data Aggregation Pharmacy Claim Load
| AttributedMedicalGroupId |
NULL |
| AttributedMedicalGroupIdType |
"Unspecified" |
Externally Adjudicated Medical Claim Load
| AttributedMedicalGroupId |
|
||
| AttributedMedicalGroupIdType |
"EpicFacilityProfileId" |
Externally Adjudicated Pharmacy Claim Load
| AttributedMedicalGroupId |
|
||
| AttributedMedicalGroupIdType |
Received Claim Load
| AttributedMedicalGroupId |
|
||
| AttributedMedicalGroupIdType |
Received Pharmacy Claim Load
| AttributedMedicalGroupId |
|
||
| AttributedMedicalGroupIdType |
BenefitPlanKey
: integerBenefit plan that was used to adjudicate the claim.
Properties
- Data type
- integer
- SQL Server data type
- bigint
- Allows null
- No
- Default value
- -1
- Delete value
- -3
Data Lineage for Each Package
CMS ACO Part A Files Load
| BenefitPlanId |
|
||
|
Benefit plan as configured through interface configuration in Chronicles |
|||
| BenefitPlanIdType |
"EpicBenefitPlanId" |
CMS ACO Part B DME File Load
| BenefitPlanId |
|
||
|
Benefit plan as configured through interface configuration in Chronicles |
|||
| BenefitPlanIdType |
"EpicBenefitPlanId" |
CMS ACO Part B Physicians File Load
| BenefitPlanId |
|
||
|
Benefit plan as configured through interface configuration in Chronicles |
|||
| BenefitPlanIdType |
"EpicBenefitPlanId" |
CMS ACO Part D Prescription Drug File Load
| BenefitPlanId |
|
||
|
Benefit plan as configured through interface configuration in Chronicles |
|||
| BenefitPlanIdType |
"EpicBenefitPlanId" |
CMS CJR DME Claim Load
| BenefitPlanId | |
| BenefitPlanIdType |
CMS CJR Home Health Claim Load
| BenefitPlanId | |
| BenefitPlanIdType |
CMS CJR Hospice Claim Load
| BenefitPlanId | |
| BenefitPlanIdType |
CMS CJR Inpatient Claim Load
| BenefitPlanId | |
| BenefitPlanIdType |
CMS CJR Outpatient Claim Load
| BenefitPlanId | |
| BenefitPlanIdType |
CMS CJR Part B Claim Load
| BenefitPlanId | |
| BenefitPlanIdType |
CMS CJR Skilled Nursing Facility Claim Load
| BenefitPlanId | |
| BenefitPlanIdType |
Data Aggregation Medical Claim Load
| BenefitPlanId |
|
||
| BenefitPlanIdType |
|
||
|
"EpicBenefitPlanId" |
Data Aggregation Pharmacy Claim Load
| BenefitPlanId |
|
||
| BenefitPlanIdType |
|
||
|
"EpicBenefitPlanId" |
Externally Adjudicated Medical Claim Load
| BenefitPlanId |
|
||
| BenefitPlanIdType |
"EpicBenefitPlanId" |
Externally Adjudicated Pharmacy Claim Load
| BenefitPlanId | |
| BenefitPlanIdType |
"Unspecified" |
Payer System Medical Claim Load
| BenefitPlanId |
|
||
| BenefitPlanIdType |
|
||
|
"EpicBenefitPlanId" |
Payer System Pharmacy Claim Load
| BenefitPlanId |
|
||
| BenefitPlanIdType |
|
||
|
"EpicBenefitPlanId" |
Received Claim Load
| BenefitPlanId |
|
||
| BenefitPlanIdType |
"EpicBenefitPlanId" |
Received Pharmacy Claim Load
| BenefitPlanId | |
| BenefitPlanIdType |
"Unspecified" |
PayerKey
: integerPayer associated with the claim
Properties
- Data type
- integer
- SQL Server data type
- bigint
- Allows null
- No
- Default value
- -1
- Delete value
- -3
Data Lineage for Each Package
CMS ACO Part A Files Load
| PayerId |
|
||||
|
If CLM_PRMRY_PYR_CD = NULL-Medicare is primary payer, C-Conditional payment by Medicare; future reimbursement expected, M-Override Code: EGHP services involved, N-Override Code: non-EGHP services involved, Y-Other secondary payer investigation shows Medicare as primary payer, or Z-Medicare is primary payer then CmsPayorEpicId component configuration for ReceivedClaimFact or payer configured in the Chronicles interface Otherwise NULL |
|||||
| PayerIdType |
|
||||
|
If CLM_PRMRY_PYR_CD = NULL-Medicare is primary payer, C-Conditional payment by Medicare; future reimbursement expected, M-Override Code: EGHP services involved, N-Override Code: non-EGHP services involved, Y-Other secondary payer investigation shows Medicare as primary payer, or Z-Medicare is primary payer then "EpicPayorId" Otherwise "NotApplicable" |
CMS ACO Part B DME File Load
| PayerId |
|
||
|
If CLM_PRMRY_PYR_CD = NULL-Medicare is primary payer, C-Conditional payment by Medicare; future reimbursement expected, M-Override Code: EGHP services involved, N-Override Code: non-EGHP services involved, Y-Other secondary payer investigation shows Medicare as primary payer, or Z-Medicare is primary payer then CmsPayorEpicId component configuration for ReceivedClaimFact or payer configured in the Chronicles interface Otherwise NULL |
|||
| PayerIdType |
|
||
|
If CLM_PRMRY_PYR_CD = NULL-Medicare is primary payer, C-Conditional payment by Medicare; future reimbursement expected, M-Override Code: EGHP services involved, N-Override Code: non-EGHP services involved, Y-Other secondary payer investigation shows Medicare as primary payer, or Z-Medicare is primary payer then "EpicPayorId" Otherwise "NotApplicable" |
CMS ACO Part B Physicians File Load
| PayerId |
|
||||
|
If CLM_PRMRY_PYR_CD = NULL-Medicare is primary payer, C-Conditional payment by Medicare; future reimbursement expected, M-Override Code: EGHP services involved, N-Override Code: non-EGHP services involved, Y-Other secondary payer investigation shows Medicare as primary payer, or Z-Medicare is primary payer then CmsPayorEpicId component configuration for ReceivedClaimFact or payer configured in the Chronicles interface Otherwise NULL |
|||||
| PayerIdType |
|
||||
|
If CLM_PRMRY_PYR_CD = NULL-Medicare is primary payer, C-Conditional payment by Medicare; future reimbursement expected, M-Override Code: EGHP services involved, N-Override Code: non-EGHP services involved, Y-Other secondary payer investigation shows Medicare as primary payer, or Z-Medicare is primary payer then "EpicPayorId" Otherwise "NotApplicable" |
CMS ACO Part D Prescription Drug File Load
| PayerId |
|
||
|
Payor as configured through ReceivedClaimFact Component Configuration or through interface configuration in Chronicles |
|||
| PayerIdType |
"EpicPayorId" |
CMS CJR DME Claim Load
| PayerId |
NULL |
| PayerIdType |
NotApplicable |
CMS CJR Home Health Claim Load
| PayerId |
NULL |
| PayerIdType |
NotApplicable |
CMS CJR Hospice Claim Load
| PayerId |
NULL |
| PayerIdType |
NotApplicable |
CMS CJR Inpatient Claim Load
| PayerId |
NULL |
| PayerIdType |
NotApplicable |
CMS CJR Outpatient Claim Load
| PayerId |
NULL |
| PayerIdType |
NotApplicable |
CMS CJR Part B Claim Load
| PayerId |
NULL |
| PayerIdType |
NotApplicable |
CMS CJR Skilled Nursing Facility Claim Load
| PayerId |
NULL |
| PayerIdType |
NotApplicable |
Data Aggregation Medical Claim Load
| PayerId |
|
||
|
If WORKFLOW_PAYOR_ID is not NULL then WORKFLOW_PAYOR_ID Otherwise NULL |
|||
| PayerIdType |
|
||
|
If WORKFLOW_PAYER_ID is not null then "EpicPayorId" Otherwise "NotApplciable" |
Data Aggregation Pharmacy Claim Load
| PayerId |
|
||
| PayerIdType |
"EpicPayorId" |
Externally Adjudicated Medical Claim Load
| PayerId | |
| PayerIdType |
"NotApplicable" |
Externally Adjudicated Pharmacy Claim Load
| PayerId | |
| PayerIdType |
"Unspecified" |
Payer System Medical Claim Load
| PayerId |
|
||
|
If WORKFLOW_PAYOR_ID is not NULL then WORKFLOW_PAYOR_ID Otherwise NULL |
|||
| PayerIdType |
|
||
|
If WORKFLOW_PAYER_ID is not null then "EpicPayorId" Otherwise "NotApplciable" |
Payer System Pharmacy Claim Load
| PayerId |
|
||
| PayerIdType |
"EpicPayorId" |
Received Claim Load
| PayerId |
|
||||||||||
|
If WORKFLOW_PAYOR_ID is not NULL then WORKFLOW_PAYOR_ID Otherwise if there does not exist a row in PLAN_GRP_BEN_PLAN for AP_CLAIM.PLAN_GROUP_ID effective on SERVICE_START_DATE if populated, SERV_DATE if not, then "*Unspecified" Otherwise PLAN_GRP_BEN_PLAN.BEN_PLAN_PAYOR_ID |
|||||||||||
| PayerIdType |
"EpicPayorId" |
Received Pharmacy Claim Load
| PayerId | |
| PayerIdType |
"Unspecified" |
VendorKey
: integerVendor that submitted the claim
Properties
- Data type
- integer
- SQL Server data type
- bigint
- Allows null
- No
- Default value
- -1
- Delete value
- -3
Data Lineage for Each Package
CMS ACO Part A Files Load
| VendorId |
NULL |
| VendorIdType |
"NotApplicable" |
CMS ACO Part B DME File Load
| VendorId |
NULL |
| VendorIdType |
"NotApplicable" |
CMS ACO Part B Physicians File Load
| VendorId |
NULL |
| VendorIdType |
"NotApplicable" |
CMS ACO Part D Prescription Drug File Load
| VendorId |
NULL |
| VendorIdType |
"NotApplicable" |
CMS CJR DME Claim Load
| VendorId |
NULL |
| VendorIdType |
NotApplicable |
CMS CJR Home Health Claim Load
| VendorId |
NULL |
| VendorIdType |
NotApplicable |
CMS CJR Hospice Claim Load
| VendorId |
NULL |
| VendorIdType |
NotApplicable |
CMS CJR Inpatient Claim Load
| VendorId |
NULL |
| VendorIdType |
NotApplicable |
CMS CJR Outpatient Claim Load
| VendorId |
NULL |
| VendorIdType |
NotApplicable |
CMS CJR Part B Claim Load
| VendorId |
NULL |
| VendorIdType |
NotApplicable |
CMS CJR Skilled Nursing Facility Claim Load
| VendorId |
NULL |
| VendorIdType |
NotApplicable |
Data Aggregation Pharmacy Claim Load
| VendorId | |
| VendorIdType |
"Unspecified" |
Externally Adjudicated Medical Claim Load
| VendorId |
|
||
| VendorIdType |
"EpicVendorId" |
Externally Adjudicated Pharmacy Claim Load
| VendorId | |
| VendorIdType |
"Unspecified" |
Payer System Pharmacy Claim Load
| VendorId | |
| VendorIdType |
"Unspecified" |
Received Claim Load
| VendorId |
|
||
| VendorIdType |
"EpicVendorId" |
Received Pharmacy Claim Load
| VendorId | |
| VendorIdType |
"Unspecified" |
PlaceOfServiceKey
: integerPlace of service associated with the claim
Properties
- Data type
- integer
- SQL Server data type
- bigint
- Allows null
- No
- Default value
- -1
- Delete value
- -3
Data Lineage for Each Package
CMS ACO Part A Files Load
| PlaceOfServiceId |
|
||
| PlaceOfServiceIdType |
"FacilityNpi" |
CMS ACO Part B DME File Load
| PlaceOfServiceId |
NULL |
| PlaceOfServiceIdType |
"NotApplicable" |
CMS ACO Part B Physicians File Load
| PlaceOfServiceId |
NULL |
| PlaceOfServiceIdType |
"NotApplicable" |
CMS ACO Part D Prescription Drug File Load
| PlaceOfServiceId |
NULL |
| PlaceOfServiceIdType |
"NotApplicable" |
CMS CJR DME Claim Load
| PlaceOfServiceId |
NULL |
| PlaceOfServiceIdType |
NotApplicable |
CMS CJR Home Health Claim Load
| PlaceOfServiceId |
|
||
| PlaceOfServiceIdType |
FacilityNpi |
CMS CJR Hospice Claim Load
| PlaceOfServiceId |
|
||
| PlaceOfServiceIdType |
FacilityCcn |
CMS CJR Inpatient Claim Load
| PlaceOfServiceId |
|
||
| PlaceOfServiceIdType |
FacilityCcn |
CMS CJR Outpatient Claim Load
| PlaceOfServiceId |
|
||
| PlaceOfServiceIdType |
FacilityCcn |
CMS CJR Part B Claim Load
| PlaceOfServiceId |
NULL |
| PlaceOfServiceIdType |
NotApplicable |
CMS CJR Skilled Nursing Facility Claim Load
| PlaceOfServiceId |
|
||
| PlaceOfServiceIdType |
FacilityCcn |
Data Aggregation Medical Claim Load
| PlaceOfServiceId |
|
||||
|
If LOC_ID is not NULL then LOC_ID Otherwise SVC_FAC_NPI |
|||||
| PlaceOfServiceIdType |
|
||||
|
If LOC_ID is not NULL then "EpicFacilityProfileId" Otherwise "FacilityNpi" |
Data Aggregation Pharmacy Claim Load
| PlaceOfServiceId | |
| PlaceOfServiceIdType |
"NotApplicable" |
Externally Adjudicated Medical Claim Load
| PlaceOfServiceId |
|
||||
|
If LOC_ID is not NULL then LOC_ID Otherwise SVC_FAC_NPI |
|||||
| PlaceOfServiceIdType |
|
||||
|
If LOC_ID is not NULL then "EpicFacilityProfileId" Otherwise "FacilityNpi" |
Externally Adjudicated Pharmacy Claim Load
| PlaceOfServiceId | |
| PlaceOfServiceIdType |
"NotApplicable" |
Payer System Medical Claim Load
| PlaceOfServiceId |
|
||||
|
If LOC_ID is not NULL then LOC_ID Otherwise SVC_FAC_NPI |
|||||
| PlaceOfServiceIdType |
|
||||
|
If LOC_ID is not NULL then "EpicFacilityProfileId" Otherwise "FacilityNpi" |
Payer System Pharmacy Claim Load
| PlaceOfServiceId | |
| PlaceOfServiceIdType |
"NotApplicable" |
Received Claim Load
| PlaceOfServiceId |
|
||||
|
If LOC_ID is not NULL then LOC_ID Otherwise SVC_FAC_NPI |
|||||
| PlaceOfServiceIdType |
|
||||
|
If LOC_ID is not NULL then "EpicFacilityProfileId" Otherwise "FacilityNpi" |
Received Pharmacy Claim Load
| PlaceOfServiceId | |
| PlaceOfServiceIdType |
"NotApplicable" |
CcnPlaceOfServiceKey
: integerPlace of service associated with the claim Centers for Medicare and Medicaid Services Certification Number (CCN)
Properties
- Data type
- integer
- SQL Server data type
- bigint
- Allows null
- No
- Default value
- -1
- Delete value
- -3
Data Lineage for Each Package
CMS ACO Part A Files Load
| CcnPlaceOfServiceId |
|
||
| CcnPlaceOfServiceIdType |
"FacilityCcn" |
CMS ACO Part B DME File Load
| CcnPlaceOfServiceId |
NULL |
| CcnPlaceOfServiceIdType |
"NotApplicable" |
CMS ACO Part B Physicians File Load
| CcnPlaceOfServiceId |
NULL |
| CcnPlaceOfServiceIdType |
"NotApplicable" |
CMS ACO Part D Prescription Drug File Load
| CcnPlaceOfServiceId |
NULL |
| CcnPlaceOfServiceIdType |
"NotApplicable" |
CMS CJR DME Claim Load
| CcnPlaceOfServiceId |
NULL |
| CcnPlaceOfServiceIdType |
NotApplicable |
CMS CJR Home Health Claim Load
| CcnPlaceOfServiceId |
|
||
| CcnPlaceOfServiceIdType |
FacilityCcn |
CMS CJR Hospice Claim Load
| CcnPlaceOfServiceId |
|
||
| CcnPlaceOfServiceIdType |
FacilityCcn |
CMS CJR Inpatient Claim Load
| CcnPlaceOfServiceId |
|
||
| CcnPlaceOfServiceIdType |
FacilityCcn |
CMS CJR Outpatient Claim Load
| CcnPlaceOfServiceId |
|
||
| CcnPlaceOfServiceIdType |
FacilityCcn |
CMS CJR Part B Claim Load
| CcnPlaceOfServiceId |
NULL |
| CcnPlaceOfServiceIdType |
NotApplicable |
CMS CJR Skilled Nursing Facility Claim Load
| CcnPlaceOfServiceId |
|
||
| CcnPlaceOfServiceIdType |
FacilityCcn |
Data Aggregation Medical Claim Load
| CcnPlaceOfServiceId |
|
||
|
NULL |
|||
| CcnPlaceOfServiceIdType |
"Unspecified" |
Data Aggregation Pharmacy Claim Load
| CcnPlaceOfServiceId | |
| CcnPlaceOfServiceIdType |
"NotApplicable" |
Externally Adjudicated Medical Claim Load
| CcnPlaceOfServiceId |
NULL |
| CcnPlaceOfServiceIdType |
"Unspecified" |
Externally Adjudicated Pharmacy Claim Load
| CcnPlaceOfServiceId | |
| CcnPlaceOfServiceIdType |
"NotApplicable" |
Payer System Medical Claim Load
| CcnPlaceOfServiceId |
|
||
|
NULL |
|||
| CcnPlaceOfServiceIdType |
"Unspecified" |
Payer System Pharmacy Claim Load
| CcnPlaceOfServiceId | |
| CcnPlaceOfServiceIdType |
"NotApplicable" |
Received Claim Load
| CcnPlaceOfServiceId |
NULL |
| CcnPlaceOfServiceIdType |
"Unspecified" |
Received Pharmacy Claim Load
| CcnPlaceOfServiceId | |
| CcnPlaceOfServiceIdType |
"NotApplicable" |
BillingProviderKey
: integerProvider under whose license number the claim was sent
Properties
- Data type
- integer
- SQL Server data type
- bigint
- Allows null
- No
- Default value
- -1
- Delete value
- -3
Data Lineage for Each Package
CMS ACO Part A Files Load
| BillingProviderId |
|
||
| BillingProviderIdType |
"EpicProviderNpi" |
||
| StartDate |
|
||
|
If CLM_FROM_DT < 1/1/1753 or CLM_FROM_DT = 12/31/9999 then NULL Otherwise CLM_FROM_DT |
CMS ACO Part B DME File Load
| BillingProviderId |
NULL |
||
| BillingProviderIdType |
"NotApplicable" |
||
| StartDate |
|
||
|
If CLM_FROM_DT < 1/1/1753 or CLM_FROM_DT = 12/31/9999 then NULL Otherwise CLM_FROM_DT |
CMS ACO Part B Physicians File Load
| BillingProviderId |
NULL |
||
| BillingProviderIdType |
"NotApplicable" |
||
| StartDate |
|
||
|
If CLM_FROM_DT < 1/1/1753 or CLM_FROM_DT = 12/31/9999 then NULL Otherwise CLM_FROM_DT |
CMS ACO Part D Prescription Drug File Load
| BillingProviderId |
NULL |
||
| BillingProviderIdType |
"NotApplicable" |
||
| StartDate |
|
||
|
If CLM_LINE_FROM_DT < 1/1/1753 or CLM_LINE_FROM_DT = 12/31/9999 then NULL Otherwise CLM_LINE_FROM_DT |
CMS CJR DME Claim Load
| BillingProviderId |
NULL |
||
| BillingProviderIdType |
NotApplicable |
||
| StartDate |
|
||
CMS CJR Home Health Claim Load
| BillingProviderId |
|
||
| BillingProviderIdType |
FacilityNpi |
||
| StartDate |
|
||
CMS CJR Hospice Claim Load
| BillingProviderId |
|
||
| BillingProviderIdType |
FacilityCcn |
||
| StartDate |
|
||
CMS CJR Inpatient Claim Load
| BillingProviderId |
|
||
| BillingProviderIdType |
FacilityCcn |
||
| StartDate |
|
||
CMS CJR Outpatient Claim Load
| BillingProviderId |
|
||
| BillingProviderIdType |
FacilityCcn |
||
| StartDate |
|
||
CMS CJR Part B Claim Load
| BillingProviderId |
NULL |
||
| BillingProviderIdType |
NotApplicable |
||
| StartDate |
|
||
CMS CJR Skilled Nursing Facility Claim Load
| BillingProviderId |
|
||
| BillingProviderIdType |
FacilityCcn |
||
| StartDate |
|
||
Data Aggregation Medical Claim Load
| BillingProviderId |
|
||||||||||
| BillingProviderIdType |
|
||||||||||
|
"EpicProviderNpi" |
|||||||||||
| StartDate |
|
||||||||||
|
Minimum of STMT_COV_FROM_DATE - Time Zone: Unspecified and SERVICE_START_DATE - Time Zone: Unspecified |
Data Aggregation Pharmacy Claim Load
| BillingProviderId | |||
| BillingProviderIdType |
"NotApplicable" |
||
| StartDate |
|
||
Externally Adjudicated Medical Claim Load
| BillingProviderId |
|
||||||||||
| BillingProviderIdType |
"EpicProviderNpi" |
||||||||||
| StartDate |
|
||||||||||
|
Minimum of STMT_COV_FROM_DATE - Time Zone: Unspecified and SERVICE_START_DATE - Time Zone: Unspecified |
Externally Adjudicated Pharmacy Claim Load
| BillingProviderId | |||
| BillingProviderIdType |
"NotApplicable" |
||
| StartDate |
|
||
Payer System Medical Claim Load
| BillingProviderId |
|
||||||||||
| BillingProviderIdType |
"EpicProviderNpi" |
||||||||||
| StartDate |
|
||||||||||
|
Minimum of STMT_COV_FROM_DATE - Time Zone: Unspecified and SERVICE_START_DATE - Time Zone: Unspecified |
Payer System Pharmacy Claim Load
| BillingProviderId | |||
| BillingProviderIdType |
"NotApplicable" |
||
| StartDate |
|
||
Received Claim Load
| BillingProviderId |
|
||||||||||
| BillingProviderIdType |
"EpicProviderNpi" |
||||||||||
| StartDate |
|
||||||||||
|
Minimum of STMT_COV_FROM_DATE - Time Zone: Unspecified and SERVICE_START_DATE - Time Zone: Unspecified |
Received Pharmacy Claim Load
| BillingProviderId | |||
| BillingProviderIdType |
"NotApplicable" |
||
| StartDate |
|
||
BillingProviderDurableKey
: integerProvider under whose license number the claim was sent
Properties
- Data type
- integer
- SQL Server data type
- bigint
- Allows null
- No
- Default value
- -1
- Delete value
- -3
Data Lineage for Each Package
CMS ACO Part A Files Load
| BillingProviderId |
|
||
| BillingProviderIdType |
"EpicProviderNpi" |
CMS ACO Part B DME File Load
| BillingProviderId |
NULL |
| BillingProviderIdType |
"NotApplicable" |
CMS ACO Part B Physicians File Load
| BillingProviderId |
NULL |
| BillingProviderIdType |
"NotApplicable" |
CMS ACO Part D Prescription Drug File Load
| BillingProviderId |
NULL |
| BillingProviderIdType |
"NotApplicable" |
CMS CJR DME Claim Load
| BillingProviderId |
NULL |
| BillingProviderIdType |
NotApplicable |
CMS CJR Home Health Claim Load
| BillingProviderId |
|
||
| BillingProviderIdType |
FacilityNpi |
CMS CJR Hospice Claim Load
| BillingProviderId |
|
||
| BillingProviderIdType |
FacilityCcn |
CMS CJR Inpatient Claim Load
| BillingProviderId |
|
||
| BillingProviderIdType |
FacilityCcn |
CMS CJR Outpatient Claim Load
| BillingProviderId |
|
||
| BillingProviderIdType |
FacilityCcn |
CMS CJR Part B Claim Load
| BillingProviderId |
NULL |
| BillingProviderIdType |
NotApplicable |
CMS CJR Skilled Nursing Facility Claim Load
| BillingProviderId |
|
||
| BillingProviderIdType |
FacilityCcn |
Data Aggregation Medical Claim Load
| BillingProviderId |
|
||||||||||
| BillingProviderIdType |
|
||||||||||
|
"EpicProviderNpi" |
Data Aggregation Pharmacy Claim Load
| BillingProviderId | |
| BillingProviderIdType |
"NotApplicable" |
Externally Adjudicated Medical Claim Load
| BillingProviderId |
|
||||||||||
| BillingProviderIdType |
"EpicProviderNpi" |
Externally Adjudicated Pharmacy Claim Load
| BillingProviderId | |
| BillingProviderIdType |
"NotApplicable" |
Payer System Medical Claim Load
| BillingProviderId |
|
||||||||||
| BillingProviderIdType |
"EpicProviderNpi" |
Payer System Pharmacy Claim Load
| BillingProviderId | |
| BillingProviderIdType |
"NotApplicable" |
Received Claim Load
| BillingProviderId |
|
||||||||||
| BillingProviderIdType |
"EpicProviderNpi" |
Received Pharmacy Claim Load
| BillingProviderId | |
| BillingProviderIdType |
"NotApplicable" |
BillingProviderSourceDataDurableKey
: integerProvider under whose license number the claim was sent
Properties
- Data type
- integer
- SQL Server data type
- bigint
- Allows null
- No
- Default value
- -1
- Delete value
- -3
Data Lineage for Each Package
CMS ACO Part A Files Load
| BillingProviderId |
|
||
| BillingProviderIdType |
"EpicProviderNpi" |
||
| BillingProviderSourceName |
"NPPES" |
CMS ACO Part B DME File Load
| BillingProviderId |
NULL |
| BillingProviderIdType |
"NotApplicable" |
| BillingProviderSourceName |
NULL |
CMS ACO Part B Physicians File Load
| BillingProviderId |
NULL |
| BillingProviderIdType |
"NotApplicable" |
| BillingProviderSourceName |
NULL |
CMS ACO Part D Prescription Drug File Load
| BillingProviderId |
NULL |
| BillingProviderIdType |
"NotApplicable" |
| BillingProviderSourceName |
NULL |
CMS CJR DME Claim Load
| BillingProviderId |
NULL |
| BillingProviderIdType |
NotApplicable |
| BillingProviderSourceName |
NULL |
CMS CJR Home Health Claim Load
| BillingProviderId |
|
||
| BillingProviderIdType |
FacilityNpi |
||
| BillingProviderSourceName |
"NPPES" |
CMS CJR Hospice Claim Load
| BillingProviderId |
|
||
| BillingProviderIdType |
FacilityCcn |
||
| BillingProviderSourceName |
NULL |
CMS CJR Inpatient Claim Load
| BillingProviderId |
|
||
| BillingProviderIdType |
FacilityCcn |
||
| BillingProviderSourceName |
"CMS" |
CMS CJR Outpatient Claim Load
| BillingProviderId |
|
||
| BillingProviderIdType |
FacilityCcn |
||
| BillingProviderSourceName |
"CMS" |
CMS CJR Part B Claim Load
| BillingProviderId |
NULL |
| BillingProviderIdType |
NotApplicable |
| BillingProviderSourceName |
NULL |
CMS CJR Skilled Nursing Facility Claim Load
| BillingProviderId |
|
||
| BillingProviderIdType |
FacilityCcn |
||
| BillingProviderSourceName |
"CMS" |
Data Aggregation Medical Claim Load
| BillingProviderId |
|
||||||||||
| BillingProviderIdType |
|
||||||||||
|
"EpicProviderNpi" |
|||||||||||
| BillingProviderSourceName |
"NPPES" |
Data Aggregation Pharmacy Claim Load
| BillingProviderId | |
| BillingProviderIdType |
"NotApplicable" |
| BillingProviderSourceName |
Externally Adjudicated Medical Claim Load
| BillingProviderId |
|
||||||||||
| BillingProviderIdType |
"EpicProviderNpi" |
||||||||||
| BillingProviderSourceName |
"NPPES" |
Externally Adjudicated Pharmacy Claim Load
| BillingProviderId | |
| BillingProviderIdType |
"NotApplicable" |
| BillingProviderSourceName |
Payer System Medical Claim Load
| BillingProviderId |
|
||||||||||
| BillingProviderIdType |
"EpicProviderNpi" |
||||||||||
| BillingProviderSourceName |
"NPPES" |
Payer System Pharmacy Claim Load
| BillingProviderId | |
| BillingProviderIdType |
"NotApplicable" |
| BillingProviderSourceName |
Received Claim Load
| BillingProviderId |
|
||||||||||
| BillingProviderIdType |
"EpicProviderNpi" |
||||||||||
| BillingProviderSourceName |
"NPPES" |
Received Pharmacy Claim Load
| BillingProviderId | |
| BillingProviderIdType |
"NotApplicable" |
| BillingProviderSourceName |
ReferringProviderKey
: integerProvider who referred the patient
Properties
- Data type
- integer
- SQL Server data type
- bigint
- Allows null
- No
- Default value
- -1
- Delete value
- -3
Data Lineage for Each Package
CMS ACO Part A Files Load
| ReferringProviderId |
NULL |
||
| ReferringProviderIdType |
"NotApplicable" |
||
| StartDate |
|
||
|
If CLM_FROM_DT < 1/1/1753 or CLM_FROM_DT = 12/31/9999 then NULL Otherwise CLM_FROM_DT |
CMS ACO Part B DME File Load
| ReferringProviderId |
NULL |
||
| ReferringProviderIdType |
"NotApplicable" |
||
| StartDate |
|
||
|
If CLM_FROM_DT < 1/1/1753 or CLM_FROM_DT = 12/31/9999 then NULL Otherwise CLM_FROM_DT |
CMS ACO Part B Physicians File Load
| ReferringProviderId |
NULL |
||
| ReferringProviderIdType |
"NotApplicable" |
||
| StartDate |
|
||
|
If CLM_FROM_DT < 1/1/1753 or CLM_FROM_DT = 12/31/9999 then NULL Otherwise CLM_FROM_DT |
CMS ACO Part D Prescription Drug File Load
| ReferringProviderId |
NULL |
||
| ReferringProviderIdType |
"NotApplicable" |
||
| StartDate |
|
||
|
If CLM_LINE_FROM_DT < 1/1/1753 or CLM_LINE_FROM_DT = 12/31/9999 then NULL Otherwise CLM_LINE_FROM_DT |
CMS CJR DME Claim Load
| ReferringProviderId |
NULL |
||
| ReferringProviderIdType |
NotApplicable |
||
| StartDate |
|
||
CMS CJR Home Health Claim Load
| ReferringProviderId |
NULL |
||
| ReferringProviderIdType |
NotApplicable |
||
| StartDate |
|
||
CMS CJR Hospice Claim Load
| ReferringProviderId |
NULL |
||
| ReferringProviderIdType |
NotApplicable |
||
| StartDate |
|
||
CMS CJR Inpatient Claim Load
| ReferringProviderId |
NULL |
||
| ReferringProviderIdType |
NotApplicable |
||
| StartDate |
|
||
CMS CJR Outpatient Claim Load
| ReferringProviderId |
NULL |
||
| ReferringProviderIdType |
NotApplicable |
||
| StartDate |
|
||
CMS CJR Part B Claim Load
| ReferringProviderId |
NULL |
||
| ReferringProviderIdType |
NotApplicable |
||
| StartDate |
|
||
CMS CJR Skilled Nursing Facility Claim Load
| ReferringProviderId |
NULL |
||
| ReferringProviderIdType |
NotApplicable |
||
| StartDate |
|
||
Data Aggregation Medical Claim Load
| ReferringProviderId |
|
||||
|
If REF_PROV_NPI is not NULL then REF_PROV_NPI Otherwise REF_PROV_ID |
|||||
| ReferringProviderIdType |
|
||||
|
If REF_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId" |
|||||
| StartDate |
|
||||
|
Minimum of STMT_COV_FROM_DATE - Time Zone: Unspecified and SERVICE_START_DATE - Time Zone: Unspecified |
Data Aggregation Pharmacy Claim Load
| ReferringProviderId | |||
| ReferringProviderIdType |
"NotApplicable" |
||
| StartDate |
|
||
Externally Adjudicated Medical Claim Load
| ReferringProviderId |
|
||||
|
If REF_PROV_NPI is not NULL then REF_PROV_NPI Otherwise REF_PROV_ID |
|||||
| ReferringProviderIdType |
|
||||
|
If REF_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId" |
|||||
| StartDate |
|
||||
|
Minimum of STMT_COV_FROM_DATE - Time Zone: Unspecified and SERVICE_START_DATE - Time Zone: Unspecified |
Externally Adjudicated Pharmacy Claim Load
| ReferringProviderId | |||
| ReferringProviderIdType |
"NotApplicable" |
||
| StartDate |
|
||
Payer System Medical Claim Load
| ReferringProviderId |
|
||||
|
If REF_PROV_NPI is not NULL then REF_PROV_NPI Otherwise REF_PROV_ID |
|||||
| ReferringProviderIdType |
|
||||
|
If REF_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId" |
|||||
| StartDate |
|
||||
|
Minimum of STMT_COV_FROM_DATE - Time Zone: Unspecified and SERVICE_START_DATE - Time Zone: Unspecified |
Payer System Pharmacy Claim Load
| ReferringProviderId | |||
| ReferringProviderIdType |
"NotApplicable" |
||
| StartDate |
|
||
Received Claim Load
| ReferringProviderId |
|
||||
|
If REF_PROV_NPI is not NULL then REF_PROV_NPI Otherwise REF_PROV_ID |
|||||
| ReferringProviderIdType |
|
||||
|
If REF_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId" |
|||||
| StartDate |
|
||||
|
Minimum of STMT_COV_FROM_DATE - Time Zone: Unspecified and SERVICE_START_DATE - Time Zone: Unspecified |
Received Pharmacy Claim Load
| ReferringProviderId | |||
| ReferringProviderIdType |
"NotApplicable" |
||
| StartDate |
|
||
ReferringProviderDurableKey
: integerProvider who referred the patient
Properties
- Data type
- integer
- SQL Server data type
- bigint
- Allows null
- No
- Default value
- -1
- Delete value
- -3
Data Lineage for Each Package
CMS ACO Part A Files Load
| ReferringProviderId |
NULL |
| ReferringProviderIdType |
"NotApplicable" |
CMS ACO Part B DME File Load
| ReferringProviderId |
NULL |
| ReferringProviderIdType |
"NotApplicable" |
CMS ACO Part B Physicians File Load
| ReferringProviderId |
NULL |
| ReferringProviderIdType |
"NotApplicable" |
CMS ACO Part D Prescription Drug File Load
| ReferringProviderId |
NULL |
| ReferringProviderIdType |
"NotApplicable" |
CMS CJR DME Claim Load
| ReferringProviderId |
NULL |
| ReferringProviderIdType |
NotApplicable |
CMS CJR Home Health Claim Load
| ReferringProviderId |
NULL |
| ReferringProviderIdType |
NotApplicable |
CMS CJR Hospice Claim Load
| ReferringProviderId |
NULL |
| ReferringProviderIdType |
NotApplicable |
CMS CJR Inpatient Claim Load
| ReferringProviderId |
NULL |
| ReferringProviderIdType |
NotApplicable |
CMS CJR Outpatient Claim Load
| ReferringProviderId |
NULL |
| ReferringProviderIdType |
NotApplicable |
CMS CJR Part B Claim Load
| ReferringProviderId |
NULL |
| ReferringProviderIdType |
NotApplicable |
CMS CJR Skilled Nursing Facility Claim Load
| ReferringProviderId |
NULL |
| ReferringProviderIdType |
NotApplicable |
Data Aggregation Medical Claim Load
| ReferringProviderId |
|
||||
|
If REF_PROV_NPI is not NULL then REF_PROV_NPI Otherwise REF_PROV_ID |
|||||
| ReferringProviderIdType |
|
||||
|
If REF_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId" |
Data Aggregation Pharmacy Claim Load
| ReferringProviderId | |
| ReferringProviderIdType |
"NotApplicable" |
Externally Adjudicated Medical Claim Load
| ReferringProviderId |
|
||||
|
If REF_PROV_NPI is not NULL then REF_PROV_NPI Otherwise REF_PROV_ID |
|||||
| ReferringProviderIdType |
|
||||
|
If REF_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId" |
Externally Adjudicated Pharmacy Claim Load
| ReferringProviderId | |
| ReferringProviderIdType |
"NotApplicable" |
Payer System Medical Claim Load
| ReferringProviderId |
|
||||
|
If REF_PROV_NPI is not NULL then REF_PROV_NPI Otherwise REF_PROV_ID |
|||||
| ReferringProviderIdType |
|
||||
|
If REF_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId" |
Payer System Pharmacy Claim Load
| ReferringProviderId | |
| ReferringProviderIdType |
"NotApplicable" |
Received Claim Load
| ReferringProviderId |
|
||||
|
If REF_PROV_NPI is not NULL then REF_PROV_NPI Otherwise REF_PROV_ID |
|||||
| ReferringProviderIdType |
|
||||
|
If REF_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId" |
Received Pharmacy Claim Load
| ReferringProviderId | |
| ReferringProviderIdType |
"NotApplicable" |
ReferringProviderSourceDataDurableKey
: integerProvider who referred the patient
Properties
- Data type
- integer
- SQL Server data type
- bigint
- Allows null
- No
- Default value
- -1
- Delete value
- -3
Data Lineage for Each Package
CMS ACO Part A Files Load
| ReferringProviderId |
NULL |
| ReferringProviderIdType |
"NotApplicable" |
| ReferringProviderSourceName |
NULL |
CMS ACO Part B DME File Load
| ReferringProviderId |
NULL |
| ReferringProviderIdType |
"NotApplicable" |
| ReferringProviderSourceName |
NULL |
CMS ACO Part B Physicians File Load
| ReferringProviderId |
NULL |
| ReferringProviderIdType |
"NotApplicable" |
| ReferringProviderSourceName |
NULL |
CMS ACO Part D Prescription Drug File Load
| ReferringProviderId |
NULL |
| ReferringProviderIdType |
"NotApplicable" |
| ReferringProviderSourceName |
NULL |
CMS CJR DME Claim Load
| ReferringProviderId |
NULL |
| ReferringProviderIdType |
NotApplicable |
| ReferringProviderSourceName |
NULL |
CMS CJR Home Health Claim Load
| ReferringProviderId |
NULL |
| ReferringProviderIdType |
NotApplicable |
| ReferringProviderSourceName |
NULL |
CMS CJR Hospice Claim Load
| ReferringProviderId |
NULL |
| ReferringProviderIdType |
NotApplicable |
| ReferringProviderSourceName |
NULL |
CMS CJR Inpatient Claim Load
| ReferringProviderId |
NULL |
| ReferringProviderIdType |
NotApplicable |
| ReferringProviderSourceName |
NULL |
CMS CJR Outpatient Claim Load
| ReferringProviderId |
NULL |
| ReferringProviderIdType |
NotApplicable |
| ReferringProviderSourceName |
NULL |
CMS CJR Part B Claim Load
| ReferringProviderId |
NULL |
| ReferringProviderIdType |
NotApplicable |
| ReferringProviderSourceName |
NULL |
CMS CJR Skilled Nursing Facility Claim Load
| ReferringProviderId |
NULL |
| ReferringProviderIdType |
NotApplicable |
| ReferringProviderSourceName |
NULL |
Data Aggregation Medical Claim Load
| ReferringProviderId |
|
||||
|
If REF_PROV_NPI is not NULL then REF_PROV_NPI Otherwise REF_PROV_ID |
|||||
| ReferringProviderIdType |
|
||||
|
If REF_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId" |
|||||
| ReferringProviderSourceName |
|
||||
|
If REF_PROV_NPI is not NULL then "NPPES" Otherwise NULL (use source of the package) |
Data Aggregation Pharmacy Claim Load
| ReferringProviderId | |
| ReferringProviderIdType |
"NotApplicable" |
| ReferringProviderSourceName |
Externally Adjudicated Medical Claim Load
| ReferringProviderId |
|
||||
|
If REF_PROV_NPI is not NULL then REF_PROV_NPI Otherwise REF_PROV_ID |
|||||
| ReferringProviderIdType |
|
||||
|
If REF_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId" |
|||||
| ReferringProviderSourceName |
|
||||
|
If REF_PROV_NPI is not NULL then "NPPES" Otherwise NULL (use source of the package) |
Externally Adjudicated Pharmacy Claim Load
| ReferringProviderId | |
| ReferringProviderIdType |
"NotApplicable" |
| ReferringProviderSourceName |
Payer System Medical Claim Load
| ReferringProviderId |
|
||||
|
If REF_PROV_NPI is not NULL then REF_PROV_NPI Otherwise REF_PROV_ID |
|||||
| ReferringProviderIdType |
|
||||
|
If REF_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId" |
|||||
| ReferringProviderSourceName |
|
||||
|
If REF_PROV_NPI is not NULL then "NPPES" Otherwise NULL (use source of the package) |
Payer System Pharmacy Claim Load
| ReferringProviderId | |
| ReferringProviderIdType |
"NotApplicable" |
| ReferringProviderSourceName |
Received Claim Load
| ReferringProviderId |
|
||||
|
If REF_PROV_NPI is not NULL then REF_PROV_NPI Otherwise REF_PROV_ID |
|||||
| ReferringProviderIdType |
|
||||
|
If REF_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId" |
|||||
| ReferringProviderSourceName |
|
||||
|
If REF_PROV_NPI is not NULL then "NPPES" Otherwise NULL (use source of the package) |
Received Pharmacy Claim Load
| ReferringProviderId | |
| ReferringProviderIdType |
"NotApplicable" |
| ReferringProviderSourceName |
RenderingProviderKey
: integerProvider who rendered the care
Properties
- Data type
- integer
- SQL Server data type
- bigint
- Allows null
- No
- Default value
- -1
- Delete value
- -3
Data Lineage for Each Package
CMS ACO Part A Files Load
| RenderingProviderId |
NULL |
||
| RenderingProviderIdType |
"NotApplicable" |
||
| StartDate |
|
||
|
If CLM_FROM_DT < 1/1/1753 or CLM_FROM_DT = 12/31/9999 then NULL Otherwise CLM_FROM_DT |
CMS ACO Part B DME File Load
| RenderingProviderId |
NULL |
||
| RenderingProviderIdType |
"NotApplicable" |
||
| StartDate |
|
||
|
If CLM_FROM_DT < 1/1/1753 or CLM_FROM_DT = 12/31/9999 then NULL Otherwise CLM_FROM_DT |
CMS ACO Part B Physicians File Load
| RenderingProviderId |
NULL |
||
| RenderingProviderIdType |
"NotApplicable" |
||
| StartDate |
|
||
|
If CLM_FROM_DT < 1/1/1753 or CLM_FROM_DT = 12/31/9999 then NULL Otherwise CLM_FROM_DT |
CMS ACO Part D Prescription Drug File Load
| RenderingProviderId |
NULL |
||
| RenderingProviderIdType |
"NotApplicable" |
||
| StartDate |
|
||
|
If CLM_LINE_FROM_DT < 1/1/1753 or CLM_LINE_FROM_DT = 12/31/9999 then NULL Otherwise CLM_LINE_FROM_DT |
CMS CJR DME Claim Load
| RenderingProviderId |
NULL |
||
| RenderingProviderIdType |
NotApplicable |
||
| StartDate |
|
||
CMS CJR Home Health Claim Load
| RenderingProviderId |
NULL |
||
| RenderingProviderIdType |
NotApplicable |
||
| StartDate |
|
||
CMS CJR Hospice Claim Load
| RenderingProviderId |
NULL |
||
| RenderingProviderIdType |
NotApplicable |
||
| StartDate |
|
||
CMS CJR Inpatient Claim Load
| RenderingProviderId |
NULL |
||
| RenderingProviderIdType |
NotApplicable |
||
| StartDate |
|
||
CMS CJR Outpatient Claim Load
| RenderingProviderId |
NULL |
||
| RenderingProviderIdType |
NotApplicable |
||
| StartDate |
|
||
CMS CJR Part B Claim Load
| RenderingProviderId |
NULL |
||
| RenderingProviderIdType |
NotApplicable |
||
| StartDate |
|
||
CMS CJR Skilled Nursing Facility Claim Load
| RenderingProviderId |
NULL |
||
| RenderingProviderIdType |
NotApplicable |
||
| StartDate |
|
||
Data Aggregation Medical Claim Load
| RenderingProviderId |
|
||||||||||||||
|
If REND_PROV_NPI is not NULL then REND_PROV_NPI Otherwise if RENDERING_PROV_ID is not NULL then RENDERING_PROV_ID Otherwise if CLAIM_FORMAT_C = 1 and DENTAL_INFO_YN = "Y" and ASST_SURG_NPI is not NULL then ASST_SURG_NPI Otherwise if CLAIM_FORMAT_C = 1 and BIL_PROV_NPI is not NULL then BIL_PROV_NPI Otherwise if CLAIM_FORMAT_C = 1 and PROV_ID is not NULL then PROV_ID |
|||||||||||||||
| RenderingProviderIdType |
|
||||||||||||||
|
If REND_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise if RENDERING_PROV_ID is not NULL then "EpicProviderId" Otherwise if CLAIM_FORMAT_C = 1 and DENTAL_INFO_YN = "Y" and ASST_SURG_NPI is not NULL then "EpicProviderNpi" Otherwise if CLAIM_FORMAT_C = 1 and BIL_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise if CLAIM_FORMAT_C = 1 and PROV_ID is not NULL then "EpicProviderId" Otherwise "EpicProviderNpi" |
|||||||||||||||
| StartDate |
|
||||||||||||||
|
Minimum of STMT_COV_FROM_DATE - Time Zone: Unspecified and SERVICE_START_DATE - Time Zone: Unspecified |
Data Aggregation Pharmacy Claim Load
| RenderingProviderId | |||
| RenderingProviderIdType |
"NotApplicable" |
||
| StartDate |
|
||
Externally Adjudicated Medical Claim Load
| RenderingProviderId |
|
||||||||||||||
|
If REND_PROV_NPI is not NULL then REND_PROV_NPI Otherwise if RENDERING_PROV_ID is not NULL then RENDERING_PROV_ID Otherwise if CLAIM_FORMAT_C = 1 and DENTAL_INFO_YN = "Y" and ASST_SURG_NPI is not NULL then ASST_SURG_NPI Otherwise if CLAIM_FORMAT_C = 1 and BIL_PROV_NPI is not NULL then BIL_PROV_NPI Otherwise if CLAIM_FORMAT_C = 1 and PROV_ID is not NULL then PROV_ID |
|||||||||||||||
| RenderingProviderIdType |
|
||||||||||||||
|
If REND_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise if RENDERING_PROV_ID is not NULL then "EpicProviderId" Otherwise if CLAIM_FORMAT_C = 1 and DENTAL_INFO_YN = "Y" and ASST_SURG_NPI is not NULL then "EpicProviderNpi" Otherwise if CLAIM_FORMAT_C = 1 and BIL_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise if CLAIM_FORMAT_C = 1 and PROV_ID is not NULL then "EpicProviderId" Otherwise "EpicProviderNpi" |
|||||||||||||||
| StartDate |
|
||||||||||||||
|
Minimum of STMT_COV_FROM_DATE - Time Zone: Unspecified and SERVICE_START_DATE - Time Zone: Unspecified |
Externally Adjudicated Pharmacy Claim Load
| RenderingProviderId | |||
| RenderingProviderIdType |
"NotApplicable" |
||
| StartDate |
|
||
Payer System Medical Claim Load
| RenderingProviderId |
|
||||||||||||||
|
If REND_PROV_NPI is not NULL then REND_PROV_NPI Otherwise if RENDERING_PROV_ID is not NULL then RENDERING_PROV_ID Otherwise if CLAIM_FORMAT_C = 1 and DENTAL_INFO_YN = "Y" and ASST_SURG_NPI is not NULL then ASST_SURG_NPI Otherwise if CLAIM_FORMAT_C = 1 and BIL_PROV_NPI is not NULL then BIL_PROV_NPI Otherwise if CLAIM_FORMAT_C = 1 and PROV_ID is not NULL then PROV_ID |
|||||||||||||||
| RenderingProviderIdType |
|
||||||||||||||
|
If REND_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise if RENDERING_PROV_ID is not NULL then "EpicProviderId" Otherwise if CLAIM_FORMAT_C = 1 and DENTAL_INFO_YN = "Y" and ASST_SURG_NPI is not NULL then "EpicProviderNpi" Otherwise if CLAIM_FORMAT_C = 1 and BIL_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise if CLAIM_FORMAT_C = 1 and PROV_ID is not NULL then "EpicProviderId" Otherwise "EpicProviderNpi" |
|||||||||||||||
| StartDate |
|
||||||||||||||
|
Minimum of STMT_COV_FROM_DATE - Time Zone: Unspecified and SERVICE_START_DATE - Time Zone: Unspecified |
Payer System Pharmacy Claim Load
| RenderingProviderId | |||
| RenderingProviderIdType |
"NotApplicable" |
||
| StartDate |
|
||
Received Claim Load
| RenderingProviderId |
|
||||||||||||||
|
If REND_PROV_NPI is not NULL then REND_PROV_NPI Otherwise if RENDERING_PROV_ID is not NULL then RENDERING_PROV_ID Otherwise if CLAIM_FORMAT_C = 1 and DENTAL_INFO_YN = "Y" and ASST_SURG_NPI is not NULL then ASST_SURG_NPI Otherwise if CLAIM_FORMAT_C = 1 and BIL_PROV_NPI is not NULL then BIL_PROV_NPI Otherwise if CLAIM_FORMAT_C = 1 and PROV_ID is not NULL then PROV_ID |
|||||||||||||||
| RenderingProviderIdType |
|
||||||||||||||
|
If REND_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise if RENDERING_PROV_ID is not NULL then "EpicProviderId" Otherwise if CLAIM_FORMAT_C = 1 and DENTAL_INFO_YN = "Y" and ASST_SURG_NPI is not NULL then "EpicProviderNpi" Otherwise if CLAIM_FORMAT_C = 1 and BIL_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise if CLAIM_FORMAT_C = 1 and PROV_ID is not NULL then "EpicProviderId" Otherwise "EpicProviderNpi" |
|||||||||||||||
| StartDate |
|
||||||||||||||
|
Minimum of STMT_COV_FROM_DATE - Time Zone: Unspecified and SERVICE_START_DATE - Time Zone: Unspecified |
Received Pharmacy Claim Load
| RenderingProviderId | |||
| RenderingProviderIdType |
"NotApplicable" |
||
| StartDate |
|
||
RenderingProviderDurableKey
: integerProvider who rendered the care
Properties
- Data type
- integer
- SQL Server data type
- bigint
- Allows null
- No
- Default value
- -1
- Delete value
- -3
Data Lineage for Each Package
CMS ACO Part A Files Load
| RenderingProviderId |
NULL |
| RenderingProviderIdType |
"NotApplicable" |
CMS ACO Part B DME File Load
| RenderingProviderId |
NULL |
| RenderingProviderIdType |
"NotApplicable" |
CMS ACO Part B Physicians File Load
| RenderingProviderId |
NULL |
| RenderingProviderIdType |
"NotApplicable" |
CMS ACO Part D Prescription Drug File Load
| RenderingProviderId |
NULL |
| RenderingProviderIdType |
"NotApplicable" |
CMS CJR DME Claim Load
| RenderingProviderId |
NULL |
| RenderingProviderIdType |
NotApplicable |
CMS CJR Home Health Claim Load
| RenderingProviderId |
NULL |
| RenderingProviderIdType |
NotApplicable |
CMS CJR Hospice Claim Load
| RenderingProviderId |
NULL |
| RenderingProviderIdType |
NotApplicable |
CMS CJR Inpatient Claim Load
| RenderingProviderId |
NULL |
| RenderingProviderIdType |
NotApplicable |
CMS CJR Outpatient Claim Load
| RenderingProviderId |
NULL |
| RenderingProviderIdType |
NotApplicable |
CMS CJR Part B Claim Load
| RenderingProviderId |
NULL |
| RenderingProviderIdType |
NotApplicable |
CMS CJR Skilled Nursing Facility Claim Load
| RenderingProviderId |
NULL |
| RenderingProviderIdType |
NotApplicable |
Data Aggregation Medical Claim Load
| RenderingProviderId |
|
||||||||||||||
|
If REND_PROV_NPI is not NULL then REND_PROV_NPI Otherwise if RENDERING_PROV_ID is not NULL then RENDERING_PROV_ID Otherwise if CLAIM_FORMAT_C = 1 and DENTAL_INFO_YN = "Y" and ASST_SURG_NPI is not NULL then ASST_SURG_NPI Otherwise if CLAIM_FORMAT_C = 1 and BIL_PROV_NPI is not NULL then BIL_PROV_NPI Otherwise if CLAIM_FORMAT_C = 1 and PROV_ID is not NULL then PROV_ID |
|||||||||||||||
| RenderingProviderIdType |
|
||||||||||||||
|
If REND_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise if RENDERING_PROV_ID is not NULL then "EpicProviderId" Otherwise if CLAIM_FORMAT_C = 1 and DENTAL_INFO_YN = "Y" and ASST_SURG_NPI is not NULL then "EpicProviderNpi" Otherwise if CLAIM_FORMAT_C = 1 and BIL_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise if CLAIM_FORMAT_C = 1 and PROV_ID is not NULL then "EpicProviderId" Otherwise "EpicProviderNpi" |
Data Aggregation Pharmacy Claim Load
| RenderingProviderId | |
| RenderingProviderIdType |
"NotApplicable" |
Externally Adjudicated Medical Claim Load
| RenderingProviderId |
|
||||||||||||||
|
If REND_PROV_NPI is not NULL then REND_PROV_NPI Otherwise if RENDERING_PROV_ID is not NULL then RENDERING_PROV_ID Otherwise if CLAIM_FORMAT_C = 1 and DENTAL_INFO_YN = "Y" and ASST_SURG_NPI is not NULL then ASST_SURG_NPI Otherwise if CLAIM_FORMAT_C = 1 and BIL_PROV_NPI is not NULL then BIL_PROV_NPI Otherwise if CLAIM_FORMAT_C = 1 and PROV_ID is not NULL then PROV_ID |
|||||||||||||||
| RenderingProviderIdType |
|
||||||||||||||
|
If REND_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise if RENDERING_PROV_ID is not NULL then "EpicProviderId" Otherwise if CLAIM_FORMAT_C = 1 and DENTAL_INFO_YN = "Y" and ASST_SURG_NPI is not NULL then "EpicProviderNpi" Otherwise if CLAIM_FORMAT_C = 1 and BIL_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise if CLAIM_FORMAT_C = 1 and PROV_ID is not NULL then "EpicProviderId" Otherwise "EpicProviderNpi" |
Externally Adjudicated Pharmacy Claim Load
| RenderingProviderId | |
| RenderingProviderIdType |
"NotApplicable" |
Payer System Medical Claim Load
| RenderingProviderId |
|
||||||||||||||
|
If REND_PROV_NPI is not NULL then REND_PROV_NPI Otherwise if RENDERING_PROV_ID is not NULL then RENDERING_PROV_ID Otherwise if CLAIM_FORMAT_C = 1 and DENTAL_INFO_YN = "Y" and ASST_SURG_NPI is not NULL then ASST_SURG_NPI Otherwise if CLAIM_FORMAT_C = 1 and BIL_PROV_NPI is not NULL then BIL_PROV_NPI Otherwise if CLAIM_FORMAT_C = 1 and PROV_ID is not NULL then PROV_ID |
|||||||||||||||
| RenderingProviderIdType |
|
||||||||||||||
|
If REND_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise if RENDERING_PROV_ID is not NULL then "EpicProviderId" Otherwise if CLAIM_FORMAT_C = 1 and DENTAL_INFO_YN = "Y" and ASST_SURG_NPI is not NULL then "EpicProviderNpi" Otherwise if CLAIM_FORMAT_C = 1 and BIL_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise if CLAIM_FORMAT_C = 1 and PROV_ID is not NULL then "EpicProviderId" Otherwise "EpicProviderNpi" |
Payer System Pharmacy Claim Load
| RenderingProviderId | |
| RenderingProviderIdType |
"NotApplicable" |
Received Claim Load
| RenderingProviderId |
|
||||||||||||||
|
If REND_PROV_NPI is not NULL then REND_PROV_NPI Otherwise if RENDERING_PROV_ID is not NULL then RENDERING_PROV_ID Otherwise if CLAIM_FORMAT_C = 1 and DENTAL_INFO_YN = "Y" and ASST_SURG_NPI is not NULL then ASST_SURG_NPI Otherwise if CLAIM_FORMAT_C = 1 and BIL_PROV_NPI is not NULL then BIL_PROV_NPI Otherwise if CLAIM_FORMAT_C = 1 and PROV_ID is not NULL then PROV_ID |
|||||||||||||||
| RenderingProviderIdType |
|
||||||||||||||
|
If REND_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise if RENDERING_PROV_ID is not NULL then "EpicProviderId" Otherwise if CLAIM_FORMAT_C = 1 and DENTAL_INFO_YN = "Y" and ASST_SURG_NPI is not NULL then "EpicProviderNpi" Otherwise if CLAIM_FORMAT_C = 1 and BIL_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise if CLAIM_FORMAT_C = 1 and PROV_ID is not NULL then "EpicProviderId" Otherwise "EpicProviderNpi" |
Received Pharmacy Claim Load
| RenderingProviderId | |
| RenderingProviderIdType |
"NotApplicable" |
RenderingProviderSourceDataDurableKey
: integerProvider who rendered the care
Properties
- Data type
- integer
- SQL Server data type
- bigint
- Allows null
- No
- Default value
- -1
- Delete value
- -3
Data Lineage for Each Package
CMS ACO Part A Files Load
| RenderingProviderId |
NULL |
| RenderingProviderIdType |
"NotApplicable" |
| RenderingProviderSourceName |
NULL |
CMS ACO Part B DME File Load
| RenderingProviderId |
NULL |
| RenderingProviderIdType |
"NotApplicable" |
| RenderingProviderSourceName |
NULL |
CMS ACO Part B Physicians File Load
| RenderingProviderId |
NULL |
| RenderingProviderIdType |
"NotApplicable" |
| RenderingProviderSourceName |
NULL |
CMS ACO Part D Prescription Drug File Load
| RenderingProviderId |
NULL |
| RenderingProviderIdType |
"NotApplicable" |
| RenderingProviderSourceName |
NULL |
CMS CJR DME Claim Load
| RenderingProviderId |
NULL |
| RenderingProviderIdType |
NotApplicable |
| RenderingProviderSourceName |
NULL |
CMS CJR Home Health Claim Load
| RenderingProviderId |
NULL |
| RenderingProviderIdType |
NotApplicable |
| RenderingProviderSourceName |
NULL |
CMS CJR Hospice Claim Load
| RenderingProviderId |
NULL |
| RenderingProviderIdType |
NotApplicable |
| RenderingProviderSourceName |
NULL |
CMS CJR Inpatient Claim Load
| RenderingProviderId |
NULL |
| RenderingProviderIdType |
NotApplicable |
| RenderingProviderSourceName |
NULL |
CMS CJR Outpatient Claim Load
| RenderingProviderId |
NULL |
| RenderingProviderIdType |
NotApplicable |
| RenderingProviderSourceName |
NULL |
CMS CJR Part B Claim Load
| RenderingProviderId |
NULL |
| RenderingProviderIdType |
NotApplicable |
| RenderingProviderSourceName |
NULL |
CMS CJR Skilled Nursing Facility Claim Load
| RenderingProviderId |
NULL |
| RenderingProviderIdType |
NotApplicable |
| RenderingProviderSourceName |
NULL |
Data Aggregation Medical Claim Load
| RenderingProviderId |
|
||||||||||||||
|
If REND_PROV_NPI is not NULL then REND_PROV_NPI Otherwise if RENDERING_PROV_ID is not NULL then RENDERING_PROV_ID Otherwise if CLAIM_FORMAT_C = 1 and DENTAL_INFO_YN = "Y" and ASST_SURG_NPI is not NULL then ASST_SURG_NPI Otherwise if CLAIM_FORMAT_C = 1 and BIL_PROV_NPI is not NULL then BIL_PROV_NPI Otherwise if CLAIM_FORMAT_C = 1 and PROV_ID is not NULL then PROV_ID |
|||||||||||||||
| RenderingProviderIdType |
|
||||||||||||||
|
If REND_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise if RENDERING_PROV_ID is not NULL then "EpicProviderId" Otherwise if CLAIM_FORMAT_C = 1 and DENTAL_INFO_YN = "Y" and ASST_SURG_NPI is not NULL then "EpicProviderNpi" Otherwise if CLAIM_FORMAT_C = 1 and BIL_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise if CLAIM_FORMAT_C = 1 and PROV_ID is not NULL then "EpicProviderId" Otherwise "EpicProviderNpi" |
|||||||||||||||
| RenderingProviderSourceName |
|
||||||||||||||
|
If REND_PROV_NPI is not NULL then "NPPES" Otherwise if RENDERING_PROV_ID is not NULL then NULL (use source of the package) Otherwise if CLAIM_FORMAT_C = 1 and DENTAL_INFO_YN = "Y" and ASST_SURG_NPI is not NULL then "NPPES" Otherwise if CLAIM_FORMAT_C = 1 and BIL_PROV_NPI is not NULL then "NPPES" Otherwise if CLAIM_FORMAT_C = 1 and PROV_ID is not NULL then NULL (use source of the package) Otherwise "NPPES" |
Data Aggregation Pharmacy Claim Load
| RenderingProviderId | |
| RenderingProviderIdType |
"NotApplicable" |
| RenderingProviderSourceName |
Externally Adjudicated Medical Claim Load
| RenderingProviderId |
|
||||||||||||||
|
If REND_PROV_NPI is not NULL then REND_PROV_NPI Otherwise if RENDERING_PROV_ID is not NULL then RENDERING_PROV_ID Otherwise if CLAIM_FORMAT_C = 1 and DENTAL_INFO_YN = "Y" and ASST_SURG_NPI is not NULL then ASST_SURG_NPI Otherwise if CLAIM_FORMAT_C = 1 and BIL_PROV_NPI is not NULL then BIL_PROV_NPI Otherwise if CLAIM_FORMAT_C = 1 and PROV_ID is not NULL then PROV_ID |
|||||||||||||||
| RenderingProviderIdType |
|
||||||||||||||
|
If REND_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise if RENDERING_PROV_ID is not NULL then "EpicProviderId" Otherwise if CLAIM_FORMAT_C = 1 and DENTAL_INFO_YN = "Y" and ASST_SURG_NPI is not NULL then "EpicProviderNpi" Otherwise if CLAIM_FORMAT_C = 1 and BIL_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise if CLAIM_FORMAT_C = 1 and PROV_ID is not NULL then "EpicProviderId" Otherwise "EpicProviderNpi" |
|||||||||||||||
| RenderingProviderSourceName |
|
||||||||||||||
|
If REND_PROV_NPI is not NULL then "NPPES" Otherwise if RENDERING_PROV_ID is not NULL then NULL (use source of the package) Otherwise if CLAIM_FORMAT_C = 1 and DENTAL_INFO_YN = "Y" and ASST_SURG_NPI is not NULL then "NPPES" Otherwise if CLAIM_FORMAT_C = 1 and BIL_PROV_NPI is not NULL then "NPPES" Otherwise if CLAIM_FORMAT_C = 1 and PROV_ID is not NULL then NULL (use source of the package) Otherwise "NPPES" |
Externally Adjudicated Pharmacy Claim Load
| RenderingProviderId | |
| RenderingProviderIdType |
"NotApplicable" |
| RenderingProviderSourceName |
Payer System Medical Claim Load
| RenderingProviderId |
|
||||||||||||||
|
If REND_PROV_NPI is not NULL then REND_PROV_NPI Otherwise if RENDERING_PROV_ID is not NULL then RENDERING_PROV_ID Otherwise if CLAIM_FORMAT_C = 1 and DENTAL_INFO_YN = "Y" and ASST_SURG_NPI is not NULL then ASST_SURG_NPI Otherwise if CLAIM_FORMAT_C = 1 and BIL_PROV_NPI is not NULL then BIL_PROV_NPI Otherwise if CLAIM_FORMAT_C = 1 and PROV_ID is not NULL then PROV_ID |
|||||||||||||||
| RenderingProviderIdType |
|
||||||||||||||
|
If REND_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise if RENDERING_PROV_ID is not NULL then "EpicProviderId" Otherwise if CLAIM_FORMAT_C = 1 and DENTAL_INFO_YN = "Y" and ASST_SURG_NPI is not NULL then "EpicProviderNpi" Otherwise if CLAIM_FORMAT_C = 1 and BIL_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise if CLAIM_FORMAT_C = 1 and PROV_ID is not NULL then "EpicProviderId" Otherwise "EpicProviderNpi" |
|||||||||||||||
| RenderingProviderSourceName |
|
||||||||||||||
|
If REND_PROV_NPI is not NULL then "NPPES" Otherwise if RENDERING_PROV_ID is not NULL then NULL (use source of the package) Otherwise if CLAIM_FORMAT_C = 1 and DENTAL_INFO_YN = "Y" and ASST_SURG_NPI is not NULL then "NPPES" Otherwise if CLAIM_FORMAT_C = 1 and BIL_PROV_NPI is not NULL then "NPPES" Otherwise if CLAIM_FORMAT_C = 1 and PROV_ID is not NULL then NULL (use source of the package) Otherwise "NPPES" |
Payer System Pharmacy Claim Load
| RenderingProviderId | |
| RenderingProviderIdType |
"NotApplicable" |
| RenderingProviderSourceName |
Received Claim Load
| RenderingProviderId |
|
||||||||||||||
|
If REND_PROV_NPI is not NULL then REND_PROV_NPI Otherwise if RENDERING_PROV_ID is not NULL then RENDERING_PROV_ID Otherwise if CLAIM_FORMAT_C = 1 and DENTAL_INFO_YN = "Y" and ASST_SURG_NPI is not NULL then ASST_SURG_NPI Otherwise if CLAIM_FORMAT_C = 1 and BIL_PROV_NPI is not NULL then BIL_PROV_NPI Otherwise if CLAIM_FORMAT_C = 1 and PROV_ID is not NULL then PROV_ID |
|||||||||||||||
| RenderingProviderIdType |
|
||||||||||||||
|
If REND_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise if RENDERING_PROV_ID is not NULL then "EpicProviderId" Otherwise if CLAIM_FORMAT_C = 1 and DENTAL_INFO_YN = "Y" and ASST_SURG_NPI is not NULL then "EpicProviderNpi" Otherwise if CLAIM_FORMAT_C = 1 and BIL_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise if CLAIM_FORMAT_C = 1 and PROV_ID is not NULL then "EpicProviderId" Otherwise "EpicProviderNpi" |
|||||||||||||||
| RenderingProviderSourceName |
|
||||||||||||||
|
If REND_PROV_NPI is not NULL then "NPPES" Otherwise if RENDERING_PROV_ID is not NULL then NULL (use source of the package) Otherwise if CLAIM_FORMAT_C = 1 and DENTAL_INFO_YN = "Y" and ASST_SURG_NPI is not NULL then "NPPES" Otherwise if CLAIM_FORMAT_C = 1 and BIL_PROV_NPI is not NULL then "NPPES" Otherwise if CLAIM_FORMAT_C = 1 and PROV_ID is not NULL then NULL (use source of the package) Otherwise "NPPES" |
Received Pharmacy Claim Load
| RenderingProviderId | |
| RenderingProviderIdType |
"NotApplicable" |
| RenderingProviderSourceName |
AttendingProviderKey
: integerProvider who managed the overall care of the admitted patient
Properties
- Data type
- integer
- SQL Server data type
- bigint
- Allows null
- No
- Default value
- -1
- Delete value
- -3
Data Lineage for Each Package
CMS ACO Part A Files Load
| AttendingProviderId |
|
||
| AttendingProviderIdType |
"EpicProviderNpi" |
||
| StartDate |
|
||
|
If CLM_FROM_DT < 1/1/1753 or CLM_FROM_DT = 12/31/9999 then NULL Otherwise CLM_FROM_DT |
CMS ACO Part B DME File Load
| AttendingProviderId |
NULL |
||
| AttendingProviderIdType |
"NotApplicable" |
||
| StartDate |
|
||
|
If CLM_FROM_DT < 1/1/1753 or CLM_FROM_DT = 12/31/9999 then NULL Otherwise CLM_FROM_DT |
CMS ACO Part B Physicians File Load
| AttendingProviderId |
NULL |
||
| AttendingProviderIdType |
"NotApplicable" |
||
| StartDate |
|
||
|
If CLM_FROM_DT < 1/1/1753 or CLM_FROM_DT = 12/31/9999 then NULL Otherwise CLM_FROM_DT |
CMS ACO Part D Prescription Drug File Load
| AttendingProviderId |
NULL |
||
| AttendingProviderIdType |
"NotApplicable" |
||
| StartDate |
|
||
|
If CLM_LINE_FROM_DT < 1/1/1753 or CLM_LINE_FROM_DT = 12/31/9999 then NULL Otherwise CLM_LINE_FROM_DT |
CMS CJR DME Claim Load
| AttendingProviderId |
NULL |
||
| AttendingProviderIdType |
NotApplicable |
||
| StartDate |
|
||
CMS CJR Home Health Claim Load
| AttendingProviderId |
|
||
| AttendingProviderIdType |
EpicProviderNpi |
||
| StartDate |
|
||
CMS CJR Hospice Claim Load
| AttendingProviderId |
NULL |
||
| AttendingProviderIdType |
NotApplicable |
||
| StartDate |
|
||
CMS CJR Inpatient Claim Load
| AttendingProviderId |
|
||
| AttendingProviderIdType |
EpicProviderNpi |
||
| StartDate |
|
||
CMS CJR Outpatient Claim Load
| AttendingProviderId |
|
||
| AttendingProviderIdType |
EpicProviderNpi |
||
| StartDate |
|
||
CMS CJR Part B Claim Load
| AttendingProviderId |
NULL |
||
| AttendingProviderIdType |
NotApplicable |
||
| StartDate |
|
||
CMS CJR Skilled Nursing Facility Claim Load
| AttendingProviderId |
|
||
| AttendingProviderIdType |
EpicProviderNpi |
||
| StartDate |
|
||
Data Aggregation Medical Claim Load
| AttendingProviderId |
|
||||
|
If ATT_PROV_NPI is not NULL then ATT_PROV_NPI Otherwise ATTEND_PROV_ID |
|||||
| AttendingProviderIdType |
|
||||
|
If ATT_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId" |
|||||
| StartDate |
|
||||
|
Minimum of STMT_COV_FROM_DATE - Time Zone: Unspecified and SERVICE_START_DATE - Time Zone: Unspecified |
Data Aggregation Pharmacy Claim Load
| AttendingProviderId | |||
| AttendingProviderIdType |
"NotApplicable" |
||
| StartDate |
|
||
Externally Adjudicated Medical Claim Load
| AttendingProviderId |
|
||||
|
If ATT_PROV_NPI is not NULL then ATT_PROV_NPI Otherwise ATTEND_PROV_ID |
|||||
| AttendingProviderIdType |
|
||||
|
If ATT_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId" |
|||||
| StartDate |
|
||||
|
Minimum of STMT_COV_FROM_DATE - Time Zone: Unspecified and SERVICE_START_DATE - Time Zone: Unspecified |
Externally Adjudicated Pharmacy Claim Load
| AttendingProviderId | |||
| AttendingProviderIdType |
"NotApplicable" |
||
| StartDate |
|
||
Payer System Medical Claim Load
| AttendingProviderId |
|
||||
|
If ATT_PROV_NPI is not NULL then ATT_PROV_NPI Otherwise ATTEND_PROV_ID |
|||||
| AttendingProviderIdType |
|
||||
|
If ATT_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId" |
|||||
| StartDate |
|
||||
|
Minimum of STMT_COV_FROM_DATE - Time Zone: Unspecified and SERVICE_START_DATE - Time Zone: Unspecified |
Payer System Pharmacy Claim Load
| AttendingProviderId | |||
| AttendingProviderIdType |
"NotApplicable" |
||
| StartDate |
|
||
Received Claim Load
| AttendingProviderId |
|
||||
|
If ATT_PROV_NPI is not NULL then ATT_PROV_NPI Otherwise ATTEND_PROV_ID |
|||||
| AttendingProviderIdType |
|
||||
|
If ATT_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId" |
|||||
| StartDate |
|
||||
|
Minimum of STMT_COV_FROM_DATE - Time Zone: Unspecified and SERVICE_START_DATE - Time Zone: Unspecified |
Received Pharmacy Claim Load
| AttendingProviderId | |||
| AttendingProviderIdType |
"NotApplicable" |
||
| StartDate |
|
||
AttendingProviderDurableKey
: integerProvider who managed the overall care of the admitted patient
Properties
- Data type
- integer
- SQL Server data type
- bigint
- Allows null
- No
- Default value
- -1
- Delete value
- -3
Data Lineage for Each Package
CMS ACO Part A Files Load
| AttendingProviderId |
|
||
| AttendingProviderIdType |
"EpicProviderNpi" |
CMS ACO Part B DME File Load
| AttendingProviderId |
NULL |
| AttendingProviderIdType |
"NotApplicable" |
CMS ACO Part B Physicians File Load
| AttendingProviderId |
NULL |
| AttendingProviderIdType |
"NotApplicable" |
CMS ACO Part D Prescription Drug File Load
| AttendingProviderId |
NULL |
| AttendingProviderIdType |
"NotApplicable" |
CMS CJR DME Claim Load
| AttendingProviderId |
NULL |
| AttendingProviderIdType |
NotApplicable |
CMS CJR Home Health Claim Load
| AttendingProviderId |
|
||
| AttendingProviderIdType |
EpicProviderNpi |
CMS CJR Hospice Claim Load
| AttendingProviderId |
NULL |
| AttendingProviderIdType |
NotApplicable |
CMS CJR Inpatient Claim Load
| AttendingProviderId |
|
||
| AttendingProviderIdType |
EpicProviderNpi |
CMS CJR Outpatient Claim Load
| AttendingProviderId |
|
||
| AttendingProviderIdType |
EpicProviderNpi |
CMS CJR Part B Claim Load
| AttendingProviderId |
NULL |
| AttendingProviderIdType |
NotApplicable |
CMS CJR Skilled Nursing Facility Claim Load
| AttendingProviderId |
|
||
| AttendingProviderIdType |
EpicProviderNpi |
Data Aggregation Medical Claim Load
| AttendingProviderId |
|
||||
|
If ATT_PROV_NPI is not NULL then ATT_PROV_NPI Otherwise ATTEND_PROV_ID |
|||||
| AttendingProviderIdType |
|
||||
|
If ATT_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId" |
Data Aggregation Pharmacy Claim Load
| AttendingProviderId | |
| AttendingProviderIdType |
"NotApplicable" |
Externally Adjudicated Medical Claim Load
| AttendingProviderId |
|
||||
|
If ATT_PROV_NPI is not NULL then ATT_PROV_NPI Otherwise ATTEND_PROV_ID |
|||||
| AttendingProviderIdType |
|
||||
|
If ATT_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId" |
Externally Adjudicated Pharmacy Claim Load
| AttendingProviderId | |
| AttendingProviderIdType |
"NotApplicable" |
Payer System Medical Claim Load
| AttendingProviderId |
|
||||
|
If ATT_PROV_NPI is not NULL then ATT_PROV_NPI Otherwise ATTEND_PROV_ID |
|||||
| AttendingProviderIdType |
|
||||
|
If ATT_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId" |
Payer System Pharmacy Claim Load
| AttendingProviderId | |
| AttendingProviderIdType |
"NotApplicable" |
Received Claim Load
| AttendingProviderId |
|
||||
|
If ATT_PROV_NPI is not NULL then ATT_PROV_NPI Otherwise ATTEND_PROV_ID |
|||||
| AttendingProviderIdType |
|
||||
|
If ATT_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId" |
Received Pharmacy Claim Load
| AttendingProviderId | |
| AttendingProviderIdType |
"NotApplicable" |
AttendingProviderSourceDataDurableKey
: integerProvider who managed the overall care of the admitted patient
Properties
- Data type
- integer
- SQL Server data type
- bigint
- Allows null
- No
- Default value
- -1
- Delete value
- -3
Data Lineage for Each Package
CMS ACO Part A Files Load
| AttendingProviderId |
|
||
| AttendingProviderIdType |
"EpicProviderNpi" |
||
| AttendingProviderSourceName |
"NPPES" |
CMS ACO Part B DME File Load
| AttendingProviderId |
NULL |
| AttendingProviderIdType |
"NotApplicable" |
| AttendingProviderSourceName |
NULL |
CMS ACO Part B Physicians File Load
| AttendingProviderId |
NULL |
| AttendingProviderIdType |
"NotApplicable" |
| AttendingProviderSourceName |
NULL |
CMS ACO Part D Prescription Drug File Load
| AttendingProviderId |
NULL |
| AttendingProviderIdType |
"NotApplicable" |
| AttendingProviderSourceName |
NULL |
CMS CJR DME Claim Load
| AttendingProviderId |
NULL |
| AttendingProviderIdType |
NotApplicable |
| AttendingProviderSourceName |
NULL |
CMS CJR Home Health Claim Load
| AttendingProviderId |
|
||
| AttendingProviderIdType |
EpicProviderNpi |
||
| AttendingProviderSourceName |
"NPPES" |
CMS CJR Hospice Claim Load
| AttendingProviderId |
NULL |
| AttendingProviderIdType |
NotApplicable |
| AttendingProviderSourceName |
NULL |
CMS CJR Inpatient Claim Load
| AttendingProviderId |
|
||
| AttendingProviderIdType |
EpicProviderNpi |
||
| AttendingProviderSourceName |
"NPPES" |
CMS CJR Outpatient Claim Load
| AttendingProviderId |
|
||
| AttendingProviderIdType |
EpicProviderNpi |
||
| AttendingProviderSourceName |
"NPPES" |
CMS CJR Part B Claim Load
| AttendingProviderId |
NULL |
| AttendingProviderIdType |
NotApplicable |
| AttendingProviderSourceName |
NULL |
CMS CJR Skilled Nursing Facility Claim Load
| AttendingProviderId |
|
||
| AttendingProviderIdType |
EpicProviderNpi |
||
| AttendingProviderSourceName |
"NPPES" |
Data Aggregation Medical Claim Load
| AttendingProviderId |
|
||||
|
If ATT_PROV_NPI is not NULL then ATT_PROV_NPI Otherwise ATTEND_PROV_ID |
|||||
| AttendingProviderIdType |
|
||||
|
If ATT_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId" |
|||||
| AttendingProviderSourceName |
|
||||
|
If ATT_PROV_NPI is not NULL then "NPPES" Otherwise NULL (use source of the package) |
Data Aggregation Pharmacy Claim Load
| AttendingProviderId | |
| AttendingProviderIdType |
"NotApplicable" |
| AttendingProviderSourceName |
Externally Adjudicated Medical Claim Load
| AttendingProviderId |
|
||||
|
If ATT_PROV_NPI is not NULL then ATT_PROV_NPI Otherwise ATTEND_PROV_ID |
|||||
| AttendingProviderIdType |
|
||||
|
If ATT_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId" |
|||||
| AttendingProviderSourceName |
|
||||
|
If ATT_PROV_NPI is not NULL then "NPPES" Otherwise NULL (use source of the package) |
Externally Adjudicated Pharmacy Claim Load
| AttendingProviderId | |
| AttendingProviderIdType |
"NotApplicable" |
| AttendingProviderSourceName |
Payer System Medical Claim Load
| AttendingProviderId |
|
||||
|
If ATT_PROV_NPI is not NULL then ATT_PROV_NPI Otherwise ATTEND_PROV_ID |
|||||
| AttendingProviderIdType |
|
||||
|
If ATT_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId" |
|||||
| AttendingProviderSourceName |
|
||||
|
If ATT_PROV_NPI is not NULL then "NPPES" Otherwise NULL (use source of the package) |
Payer System Pharmacy Claim Load
| AttendingProviderId | |
| AttendingProviderIdType |
"NotApplicable" |
| AttendingProviderSourceName |
Received Claim Load
| AttendingProviderId |
|
||||
|
If ATT_PROV_NPI is not NULL then ATT_PROV_NPI Otherwise ATTEND_PROV_ID |
|||||
| AttendingProviderIdType |
|
||||
|
If ATT_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId" |
|||||
| AttendingProviderSourceName |
|
||||
|
If ATT_PROV_NPI is not NULL then "NPPES" Otherwise NULL (use source of the package) |
Received Pharmacy Claim Load
| AttendingProviderId | |
| AttendingProviderIdType |
"NotApplicable" |
| AttendingProviderSourceName |
OperatingProviderKey
: integerProvider who had the primary responsibility for performing the surgical procedure
Properties
- Data type
- integer
- SQL Server data type
- bigint
- Allows null
- No
- Default value
- -1
- Delete value
- -3
Data Lineage for Each Package
CMS ACO Part A Files Load
| OperatingProviderId |
|
||
| OperatingProviderIdType |
"EpicProviderNpi" |
||
| StartDate |
|
||
|
If CLM_FROM_DT < 1/1/1753 or CLM_FROM_DT = 12/31/9999 then NULL Otherwise CLM_FROM_DT |
CMS ACO Part B DME File Load
| OperatingProviderId |
NULL |
||
| OperatingProviderIdType |
"NotApplicable" |
||
| StartDate |
|
||
|
If CLM_FROM_DT < 1/1/1753 or CLM_FROM_DT = 12/31/9999 then NULL Otherwise CLM_FROM_DT |
CMS ACO Part B Physicians File Load
| OperatingProviderId |
NULL |
||
| OperatingProviderIdType |
"NotApplicable" |
||
| StartDate |
|
||
|
If CLM_FROM_DT < 1/1/1753 or CLM_FROM_DT = 12/31/9999 then NULL Otherwise CLM_FROM_DT |
CMS ACO Part D Prescription Drug File Load
| OperatingProviderId |
NULL |
||
| OperatingProviderIdType |
"NotApplicable" |
||
| StartDate |
|
||
|
If CLM_LINE_FROM_DT < 1/1/1753 or CLM_LINE_FROM_DT = 12/31/9999 then NULL Otherwise CLM_LINE_FROM_DT |
CMS CJR DME Claim Load
| OperatingProviderId |
NULL |
||
| OperatingProviderIdType |
NotApplicable |
||
| StartDate |
|
||
CMS CJR Home Health Claim Load
| OperatingProviderId |
|
||
| OperatingProviderIdType |
EpicProviderNpi |
||
| StartDate |
|
||
CMS CJR Hospice Claim Load
| OperatingProviderId |
NULL |
||
| OperatingProviderIdType |
NotApplicable |
||
| StartDate |
|
||
CMS CJR Inpatient Claim Load
| OperatingProviderId |
|
||
| OperatingProviderIdType |
EpicProviderNpi |
||
| StartDate |
|
||
CMS CJR Outpatient Claim Load
| OperatingProviderId |
|
||
| OperatingProviderIdType |
EpicProviderNpi |
||
| StartDate |
|
||
CMS CJR Part B Claim Load
| OperatingProviderId |
NULL |
||
| OperatingProviderIdType |
NotApplicable |
||
| StartDate |
|
||
CMS CJR Skilled Nursing Facility Claim Load
| OperatingProviderId |
|
||
| OperatingProviderIdType |
"EpicProviderNpi" |
||
| StartDate |
|
||
Data Aggregation Medical Claim Load
| OperatingProviderId |
|
||||
|
If OPER_PROV_NPI is not NULL then OPER_PROV_NPI Otherwise OPERATING_PROV_ID |
|||||
| OperatingProviderIdType |
|
||||
|
If OPER_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId" |
|||||
| StartDate |
|
||||
|
Minimum of STMT_COV_FROM_DATE - Time Zone: Unspecified and SERVICE_START_DATE - Time Zone: Unspecified |
Data Aggregation Pharmacy Claim Load
| OperatingProviderId | |||
| OperatingProviderIdType |
"NotApplicable" |
||
| StartDate |
|
||
Externally Adjudicated Medical Claim Load
| OperatingProviderId |
|
||||
|
If OPER_PROV_NPI is not NULL then OPER_PROV_NPI Otherwise OPERATING_PROV_ID |
|||||
| OperatingProviderIdType |
|
||||
|
If OPER_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId" |
|||||
| StartDate |
|
||||
|
Minimum of STMT_COV_FROM_DATE - Time Zone: Unspecified and SERVICE_START_DATE - Time Zone: Unspecified |
Externally Adjudicated Pharmacy Claim Load
| OperatingProviderId | |||
| OperatingProviderIdType |
"NotApplicable" |
||
| StartDate |
|
||
Payer System Medical Claim Load
| OperatingProviderId |
|
||||
|
If OPER_PROV_NPI is not NULL then OPER_PROV_NPI Otherwise OPERATING_PROV_ID |
|||||
| OperatingProviderIdType |
|
||||
|
If OPER_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId" |
|||||
| StartDate |
|
||||
|
Minimum of STMT_COV_FROM_DATE - Time Zone: Unspecified and SERVICE_START_DATE - Time Zone: Unspecified |
Payer System Pharmacy Claim Load
| OperatingProviderId | |||
| OperatingProviderIdType |
"NotApplicable" |
||
| StartDate |
|
||
Received Claim Load
| OperatingProviderId |
|
||||
|
If OPER_PROV_NPI is not NULL then OPER_PROV_NPI Otherwise OPERATING_PROV_ID |
|||||
| OperatingProviderIdType |
|
||||
|
If OPER_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId" |
|||||
| StartDate |
|
||||
|
Minimum of STMT_COV_FROM_DATE - Time Zone: Unspecified and SERVICE_START_DATE - Time Zone: Unspecified |
Received Pharmacy Claim Load
| OperatingProviderId | |||
| OperatingProviderIdType |
"NotApplicable" |
||
| StartDate |
|
||
OperatingProviderDurableKey
: integerProvider who had the primary responsibility for performing the surgical procedure
Properties
- Data type
- integer
- SQL Server data type
- bigint
- Allows null
- No
- Default value
- -1
- Delete value
- -3
Data Lineage for Each Package
CMS ACO Part A Files Load
| OperatingProviderId |
|
||
| OperatingProviderIdType |
"EpicProviderNpi" |
CMS ACO Part B DME File Load
| OperatingProviderId |
NULL |
| OperatingProviderIdType |
"NotApplicable" |
CMS ACO Part B Physicians File Load
| OperatingProviderId |
NULL |
| OperatingProviderIdType |
"NotApplicable" |
CMS ACO Part D Prescription Drug File Load
| OperatingProviderId |
NULL |
| OperatingProviderIdType |
"NotApplicable" |
CMS CJR DME Claim Load
| OperatingProviderId |
NULL |
| OperatingProviderIdType |
NotApplicable |
CMS CJR Home Health Claim Load
| OperatingProviderId |
|
||
| OperatingProviderIdType |
EpicProviderNpi |
CMS CJR Hospice Claim Load
| OperatingProviderId |
NULL |
| OperatingProviderIdType |
NotApplicable |
CMS CJR Inpatient Claim Load
| OperatingProviderId |
|
||
| OperatingProviderIdType |
EpicProviderNpi |
CMS CJR Outpatient Claim Load
| OperatingProviderId |
|
||
| OperatingProviderIdType |
EpicProviderNpi |
CMS CJR Part B Claim Load
| OperatingProviderId |
NULL |
| OperatingProviderIdType |
NotApplicable |
CMS CJR Skilled Nursing Facility Claim Load
| OperatingProviderId |
|
||
| OperatingProviderIdType |
"EpicProviderNpi" |
Data Aggregation Medical Claim Load
| OperatingProviderId |
|
||||
|
If OPER_PROV_NPI is not NULL then OPER_PROV_NPI Otherwise OPERATING_PROV_ID |
|||||
| OperatingProviderIdType |
|
||||
|
If OPER_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId" |
Data Aggregation Pharmacy Claim Load
| OperatingProviderId | |
| OperatingProviderIdType |
"NotApplicable" |
Externally Adjudicated Medical Claim Load
| OperatingProviderId |
|
||||
|
If OPER_PROV_NPI is not NULL then OPER_PROV_NPI Otherwise OPERATING_PROV_ID |
|||||
| OperatingProviderIdType |
|
||||
|
If OPER_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId" |
Externally Adjudicated Pharmacy Claim Load
| OperatingProviderId | |
| OperatingProviderIdType |
"NotApplicable" |
Payer System Medical Claim Load
| OperatingProviderId |
|
||||
|
If OPER_PROV_NPI is not NULL then OPER_PROV_NPI Otherwise OPERATING_PROV_ID |
|||||
| OperatingProviderIdType |
|
||||
|
If OPER_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId" |
Payer System Pharmacy Claim Load
| OperatingProviderId | |
| OperatingProviderIdType |
"NotApplicable" |
Received Claim Load
| OperatingProviderId |
|
||||
|
If OPER_PROV_NPI is not NULL then OPER_PROV_NPI Otherwise OPERATING_PROV_ID |
|||||
| OperatingProviderIdType |
|
||||
|
If OPER_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId" |
Received Pharmacy Claim Load
| OperatingProviderId | |
| OperatingProviderIdType |
"NotApplicable" |
OperatingProviderSourceDataDurableKey
: integerProvider who had the primary responsibility for performing the surgical procedure
Properties
- Data type
- integer
- SQL Server data type
- bigint
- Allows null
- No
- Default value
- -1
- Delete value
- -3
Data Lineage for Each Package
CMS ACO Part A Files Load
| OperatingProviderId |
|
||
| OperatingProviderIdType |
"EpicProviderNpi" |
||
| OperatingProviderSourceName |
"NPPES" |
CMS ACO Part B DME File Load
| OperatingProviderId |
NULL |
| OperatingProviderIdType |
"NotApplicable" |
| OperatingProviderSourceName |
NULL |
CMS ACO Part B Physicians File Load
| OperatingProviderId |
NULL |
| OperatingProviderIdType |
"NotApplicable" |
| OperatingProviderSourceName |
NULL |
CMS ACO Part D Prescription Drug File Load
| OperatingProviderId |
NULL |
| OperatingProviderIdType |
"NotApplicable" |
| OperatingProviderSourceName |
NULL |
CMS CJR DME Claim Load
| OperatingProviderId |
NULL |
| OperatingProviderIdType |
NotApplicable |
| OperatingProviderSourceName |
NULL |
CMS CJR Home Health Claim Load
| OperatingProviderId |
|
||
| OperatingProviderIdType |
EpicProviderNpi |
||
| OperatingProviderSourceName |
"NPPES" |
CMS CJR Hospice Claim Load
| OperatingProviderId |
NULL |
| OperatingProviderIdType |
NotApplicable |
| OperatingProviderSourceName |
NULL |
CMS CJR Inpatient Claim Load
| OperatingProviderId |
|
||
| OperatingProviderIdType |
EpicProviderNpi |
||
| OperatingProviderSourceName |
"NPPES" |
CMS CJR Outpatient Claim Load
| OperatingProviderId |
|
||
| OperatingProviderIdType |
EpicProviderNpi |
||
| OperatingProviderSourceName |
"NPPES" |
CMS CJR Part B Claim Load
| OperatingProviderId |
NULL |
| OperatingProviderIdType |
NotApplicable |
| OperatingProviderSourceName |
NULL |
CMS CJR Skilled Nursing Facility Claim Load
| OperatingProviderId |
|
||
| OperatingProviderIdType |
"EpicProviderNpi" |
||
| OperatingProviderSourceName |
"NPPES" |
Data Aggregation Medical Claim Load
| OperatingProviderId |
|
||||
|
If OPER_PROV_NPI is not NULL then OPER_PROV_NPI Otherwise OPERATING_PROV_ID |
|||||
| OperatingProviderIdType |
|
||||
|
If OPER_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId" |
|||||
| OperatingProviderSourceName |
|
||||
|
If OPER_PROV_NPI is not NULL then "NPPES" Otherwise NULL (use source of the package) |
Data Aggregation Pharmacy Claim Load
| OperatingProviderId | |
| OperatingProviderIdType |
"NotApplicable" |
| OperatingProviderSourceName |
Externally Adjudicated Medical Claim Load
| OperatingProviderId |
|
||||
|
If OPER_PROV_NPI is not NULL then OPER_PROV_NPI Otherwise OPERATING_PROV_ID |
|||||
| OperatingProviderIdType |
|
||||
|
If OPER_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId" |
|||||
| OperatingProviderSourceName |
|
||||
|
If OPER_PROV_NPI is not NULL then "NPPES" Otherwise NULL (use source of the package) |
Externally Adjudicated Pharmacy Claim Load
| OperatingProviderId | |
| OperatingProviderIdType |
"NotApplicable" |
| OperatingProviderSourceName |
Payer System Medical Claim Load
| OperatingProviderId |
|
||||
|
If OPER_PROV_NPI is not NULL then OPER_PROV_NPI Otherwise OPERATING_PROV_ID |
|||||
| OperatingProviderIdType |
|
||||
|
If OPER_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId" |
|||||
| OperatingProviderSourceName |
|
||||
|
If OPER_PROV_NPI is not NULL then "NPPES" Otherwise NULL (use source of the package) |
Payer System Pharmacy Claim Load
| OperatingProviderId | |
| OperatingProviderIdType |
"NotApplicable" |
| OperatingProviderSourceName |
Received Claim Load
| OperatingProviderId |
|
||||
|
If OPER_PROV_NPI is not NULL then OPER_PROV_NPI Otherwise OPERATING_PROV_ID |
|||||
| OperatingProviderIdType |
|
||||
|
If OPER_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId" |
|||||
| OperatingProviderSourceName |
|
||||
|
If OPER_PROV_NPI is not NULL then "NPPES" Otherwise NULL (use source of the package) |
Received Pharmacy Claim Load
| OperatingProviderId | |
| OperatingProviderIdType |
"NotApplicable" |
| OperatingProviderSourceName |
OtherProviderKey
: integerOther provider associated with the claim
Properties
- Data type
- integer
- SQL Server data type
- bigint
- Allows null
- No
- Default value
- -1
- Delete value
- -3
Data Lineage for Each Package
CMS ACO Part A Files Load
| OtherProviderId |
|
||
| OtherProviderIdType |
"EpicProviderNpi" |
||
| StartDate |
|
||
|
If CLM_FROM_DT < 1/1/1753 or CLM_FROM_DT = 12/31/9999 then NULL Otherwise CLM_FROM_DT |
CMS ACO Part B DME File Load
| OtherProviderId |
NULL |
||
| OtherProviderIdType |
"NotApplicable" |
||
| StartDate |
|
||
|
If CLM_FROM_DT < 1/1/1753 or CLM_FROM_DT = 12/31/9999 then NULL Otherwise CLM_FROM_DT |
CMS ACO Part B Physicians File Load
| OtherProviderId |
NULL |
||
| OtherProviderIdType |
"NotApplicable" |
||
| StartDate |
|
||
|
If CLM_FROM_DT < 1/1/1753 or CLM_FROM_DT = 12/31/9999 then NULL Otherwise CLM_FROM_DT |
CMS ACO Part D Prescription Drug File Load
| OtherProviderId |
NULL |
||
| OtherProviderIdType |
"NotApplicable" |
||
| StartDate |
|
||
|
If CLM_LINE_FROM_DT < 1/1/1753 or CLM_LINE_FROM_DT = 12/31/9999 then NULL Otherwise CLM_LINE_FROM_DT |
CMS CJR DME Claim Load
| OtherProviderId |
NULL |
||
| OtherProviderIdType |
NotApplicable |
||
| StartDate |
|
||
CMS CJR Home Health Claim Load
| OtherProviderId |
NULL |
||
| OtherProviderIdType |
NotApplicable |
||
| StartDate |
|
||
CMS CJR Hospice Claim Load
| OtherProviderId |
NULL |
||
| OtherProviderIdType |
NotApplicable |
||
| StartDate |
|
||
CMS CJR Inpatient Claim Load
| OtherProviderId |
NULL |
||
| OtherProviderIdType |
NotApplicable |
||
| StartDate |
|
||
CMS CJR Outpatient Claim Load
| OtherProviderId |
NULL |
||
| OtherProviderIdType |
NotApplicable |
||
| StartDate |
|
||
CMS CJR Part B Claim Load
| OtherProviderId |
NULL |
||
| OtherProviderIdType |
NotApplicable |
||
| StartDate |
|
||
CMS CJR Skilled Nursing Facility Claim Load
| OtherProviderId |
NULL |
||
| OtherProviderIdType |
NotApplicable |
||
| StartDate |
|
||
Data Aggregation Medical Claim Load
| OtherProviderId |
|
||||
|
If OTH_PROV_NPI is not NULL then OTH_PROV_NPI Otherwise OTHER_PROV_ID |
|||||
| OtherProviderIdType |
|
||||
|
If OTH_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId" |
|||||
| StartDate |
|
||||
|
Minimum of STMT_COV_FROM_DATE - Time Zone: Unspecified and SERVICE_START_DATE - Time Zone: Unspecified |
Data Aggregation Pharmacy Claim Load
| OtherProviderId | |||
| OtherProviderIdType |
"NotApplicable" |
||
| StartDate |
|
||
Externally Adjudicated Medical Claim Load
| OtherProviderId |
|
||||
|
If OTH_PROV_NPI is not NULL then OTH_PROV_NPI Otherwise OTHER_PROV_ID |
|||||
| OtherProviderIdType |
|
||||
|
If OTH_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId" |
|||||
| StartDate |
|
||||
|
Minimum of STMT_COV_FROM_DATE - Time Zone: Unspecified and SERVICE_START_DATE - Time Zone: Unspecified |
Externally Adjudicated Pharmacy Claim Load
| OtherProviderId | |||
| OtherProviderIdType |
"NotApplicable" |
||
| StartDate |
|
||
Payer System Medical Claim Load
| OtherProviderId |
|
||||
|
If OTH_PROV_NPI is not NULL then OTH_PROV_NPI Otherwise OTHER_PROV_ID |
|||||
| OtherProviderIdType |
|
||||
|
If OTH_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId" |
|||||
| StartDate |
|
||||
|
Minimum of STMT_COV_FROM_DATE - Time Zone: Unspecified and SERVICE_START_DATE - Time Zone: Unspecified |
Payer System Pharmacy Claim Load
| OtherProviderId | |||
| OtherProviderIdType |
"NotApplicable" |
||
| StartDate |
|
||
Received Claim Load
| OtherProviderId |
|
||||
|
If OTH_PROV_NPI is not NULL then OTH_PROV_NPI Otherwise OTHER_PROV_ID |
|||||
| OtherProviderIdType |
|
||||
|
If OTH_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId" |
|||||
| StartDate |
|
||||
|
Minimum of STMT_COV_FROM_DATE - Time Zone: Unspecified and SERVICE_START_DATE - Time Zone: Unspecified |
Received Pharmacy Claim Load
| OtherProviderId | |||
| OtherProviderIdType |
"NotApplicable" |
||
| StartDate |
|
||
OtherProviderDurableKey
: integerOther provider associated with the claim
Properties
- Data type
- integer
- SQL Server data type
- bigint
- Allows null
- No
- Default value
- -1
- Delete value
- -3
Data Lineage for Each Package
CMS ACO Part A Files Load
| OtherProviderId |
|
||
| OtherProviderIdType |
"EpicProviderNpi" |
CMS ACO Part B DME File Load
| OtherProviderId |
NULL |
| OtherProviderIdType |
"NotApplicable" |
CMS ACO Part B Physicians File Load
| OtherProviderId |
NULL |
| OtherProviderIdType |
"NotApplicable" |
CMS ACO Part D Prescription Drug File Load
| OtherProviderId |
NULL |
| OtherProviderIdType |
"NotApplicable" |
CMS CJR DME Claim Load
| OtherProviderId |
NULL |
| OtherProviderIdType |
NotApplicable |
CMS CJR Home Health Claim Load
| OtherProviderId |
NULL |
| OtherProviderIdType |
NotApplicable |
CMS CJR Hospice Claim Load
| OtherProviderId |
NULL |
| OtherProviderIdType |
NotApplicable |
CMS CJR Inpatient Claim Load
| OtherProviderId |
NULL |
| OtherProviderIdType |
NotApplicable |
CMS CJR Outpatient Claim Load
| OtherProviderId |
NULL |
| OtherProviderIdType |
NotApplicable |
CMS CJR Part B Claim Load
| OtherProviderId |
NULL |
| OtherProviderIdType |
NotApplicable |
CMS CJR Skilled Nursing Facility Claim Load
| OtherProviderId |
NULL |
| OtherProviderIdType |
NotApplicable |
Data Aggregation Medical Claim Load
| OtherProviderId |
|
||||
|
If OTH_PROV_NPI is not NULL then OTH_PROV_NPI Otherwise OTHER_PROV_ID |
|||||
| OtherProviderIdType |
|
||||
|
If OTH_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId" |
Data Aggregation Pharmacy Claim Load
| OtherProviderId | |
| OtherProviderIdType |
"NotApplicable" |
Externally Adjudicated Medical Claim Load
| OtherProviderId |
|
||||
|
If OTH_PROV_NPI is not NULL then OTH_PROV_NPI Otherwise OTHER_PROV_ID |
|||||
| OtherProviderIdType |
|
||||
|
If OTH_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId" |
Externally Adjudicated Pharmacy Claim Load
| OtherProviderId | |
| OtherProviderIdType |
"NotApplicable" |
Payer System Medical Claim Load
| OtherProviderId |
|
||||
|
If OTH_PROV_NPI is not NULL then OTH_PROV_NPI Otherwise OTHER_PROV_ID |
|||||
| OtherProviderIdType |
|
||||
|
If OTH_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId" |
Payer System Pharmacy Claim Load
| OtherProviderId | |
| OtherProviderIdType |
"NotApplicable" |
Received Claim Load
| OtherProviderId |
|
||||
|
If OTH_PROV_NPI is not NULL then OTH_PROV_NPI Otherwise OTHER_PROV_ID |
|||||
| OtherProviderIdType |
|
||||
|
If OTH_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId" |
Received Pharmacy Claim Load
| OtherProviderId | |
| OtherProviderIdType |
"NotApplicable" |
OtherProviderSourceDataDurableKey
: integerOther provider associated with the claim
Properties
- Data type
- integer
- SQL Server data type
- bigint
- Allows null
- No
- Default value
- -1
- Delete value
- -3
Data Lineage for Each Package
CMS ACO Part A Files Load
| OtherProviderId |
|
||
| OtherProviderIdType |
"EpicProviderNpi" |
||
| OtherProviderSourceName |
"NPPES" |
CMS ACO Part B DME File Load
| OtherProviderId |
NULL |
| OtherProviderIdType |
"NotApplicable" |
| OtherProviderSourceName |
NULL |
CMS ACO Part B Physicians File Load
| OtherProviderId |
NULL |
| OtherProviderIdType |
"NotApplicable" |
| OtherProviderSourceName |
NULL |
CMS ACO Part D Prescription Drug File Load
| OtherProviderId |
NULL |
| OtherProviderIdType |
"NotApplicable" |
| OtherProviderSourceName |
NULL |
CMS CJR DME Claim Load
| OtherProviderId |
NULL |
| OtherProviderIdType |
NotApplicable |
| OtherProviderSourceName |
NULL |
CMS CJR Home Health Claim Load
| OtherProviderId |
NULL |
| OtherProviderIdType |
NotApplicable |
| OtherProviderSourceName |
NULL |
CMS CJR Hospice Claim Load
| OtherProviderId |
NULL |
| OtherProviderIdType |
NotApplicable |
| OtherProviderSourceName |
NULL |
CMS CJR Inpatient Claim Load
| OtherProviderId |
NULL |
| OtherProviderIdType |
NotApplicable |
| OtherProviderSourceName |
NULL |
CMS CJR Outpatient Claim Load
| OtherProviderId |
NULL |
| OtherProviderIdType |
NotApplicable |
| OtherProviderSourceName |
NULL |
CMS CJR Part B Claim Load
| OtherProviderId |
NULL |
| OtherProviderIdType |
NotApplicable |
| OtherProviderSourceName |
NULL |
CMS CJR Skilled Nursing Facility Claim Load
| OtherProviderId |
NULL |
| OtherProviderIdType |
NotApplicable |
| OtherProviderSourceName |
NULL |
Data Aggregation Medical Claim Load
| OtherProviderId |
|
||||
|
If OTH_PROV_NPI is not NULL then OTH_PROV_NPI Otherwise OTHER_PROV_ID |
|||||
| OtherProviderIdType |
|
||||
|
If OTH_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId" |
|||||
| OtherProviderSourceName |
|
||||
|
If OTH_PROV_NPI is not NULL then "NPPES" Otherwise NULL (use source of the package) |
Data Aggregation Pharmacy Claim Load
| OtherProviderId | |
| OtherProviderIdType |
"NotApplicable" |
| OtherProviderSourceName |
Externally Adjudicated Medical Claim Load
| OtherProviderId |
|
||||
|
If OTH_PROV_NPI is not NULL then OTH_PROV_NPI Otherwise OTHER_PROV_ID |
|||||
| OtherProviderIdType |
|
||||
|
If OTH_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId" |
|||||
| OtherProviderSourceName |
|
||||
|
If OTH_PROV_NPI is not NULL then "NPPES" Otherwise NULL (use source of the package) |
Externally Adjudicated Pharmacy Claim Load
| OtherProviderId | |
| OtherProviderIdType |
"NotApplicable" |
| OtherProviderSourceName |
Payer System Medical Claim Load
| OtherProviderId |
|
||||
|
If OTH_PROV_NPI is not NULL then OTH_PROV_NPI Otherwise OTHER_PROV_ID |
|||||
| OtherProviderIdType |
|
||||
|
If OTH_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId" |
|||||
| OtherProviderSourceName |
|
||||
|
If OTH_PROV_NPI is not NULL then "NPPES" Otherwise NULL (use source of the package) |
Payer System Pharmacy Claim Load
| OtherProviderId | |
| OtherProviderIdType |
"NotApplicable" |
| OtherProviderSourceName |
Received Claim Load
| OtherProviderId |
|
||||
|
If OTH_PROV_NPI is not NULL then OTH_PROV_NPI Otherwise OTHER_PROV_ID |
|||||
| OtherProviderIdType |
|
||||
|
If OTH_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId" |
|||||
| OtherProviderSourceName |
|
||||
|
If OTH_PROV_NPI is not NULL then "NPPES" Otherwise NULL (use source of the package) |
Received Pharmacy Claim Load
| OtherProviderId | |
| OtherProviderIdType |
"NotApplicable" |
| OtherProviderSourceName |
PrescribingProviderKey
: integerProvider who prescribed the medication
Properties
- Data type
- integer
- SQL Server data type
- bigint
- Allows null
- No
- Default value
- -1
- Delete value
- -3
Data Lineage for Each Package
CMS ACO Part A Files Load
| PrescribingProviderId |
NULL |
||
| PrescribingProviderIdType |
"NotApplicable" |
||
| StartDate |
|
||
|
If CLM_FROM_DT < 1/1/1753 or CLM_FROM_DT = 12/31/9999 then NULL Otherwise CLM_FROM_DT |
CMS ACO Part B DME File Load
| PrescribingProviderId |
NULL |
||
| PrescribingProviderIdType |
"NotApplicable" |
||
| StartDate |
|
||
|
If CLM_FROM_DT < 1/1/1753 or CLM_FROM_DT = 12/31/9999 then NULL Otherwise CLM_FROM_DT |
CMS ACO Part B Physicians File Load
| PrescribingProviderId |
NULL |
||
| PrescribingProviderIdType |
"NotApplicable" |
||
| StartDate |
|
||
|
If CLM_FROM_DT < 1/1/1753 or CLM_FROM_DT = 12/31/9999 then NULL Otherwise CLM_FROM_DT |
CMS ACO Part D Prescription Drug File Load
| PrescribingProviderId |
|
||||
|
If PRVDR_PRSBNG_ID_QLFYR_CD = 01-NPI Number then CLM_PRSBNG_PRVDR_GNRC_ID_NUM |
|||||
| PrescribingProviderIdType |
"EpicProviderNpi" |
||||
| StartDate |
|
||||
|
If CLM_LINE_FROM_DT < 1/1/1753 or CLM_LINE_FROM_DT = 12/31/9999 then NULL Otherwise CLM_LINE_FROM_DT |
CMS CJR DME Claim Load
| PrescribingProviderId |
NULL |
||
| PrescribingProviderIdType |
NotApplicable |
||
| StartDate |
|
||
CMS CJR Home Health Claim Load
| PrescribingProviderId |
NULL |
||
| PrescribingProviderIdType |
NotApplicable |
||
| StartDate |
|
||
CMS CJR Hospice Claim Load
| PrescribingProviderId |
NULL |
||
| PrescribingProviderIdType |
NotApplicable |
||
| StartDate |
|
||
CMS CJR Inpatient Claim Load
| PrescribingProviderId |
NULL |
||
| PrescribingProviderIdType |
NotApplicable |
||
| StartDate |
|
||
CMS CJR Outpatient Claim Load
| PrescribingProviderId |
NULL |
||
| PrescribingProviderIdType |
NotApplicable |
||
| StartDate |
|
||
CMS CJR Part B Claim Load
| PrescribingProviderId |
NULL |
||
| PrescribingProviderIdType |
NotApplicable |
||
| StartDate |
|
||
CMS CJR Skilled Nursing Facility Claim Load
| PrescribingProviderId |
NULL |
||
| PrescribingProviderIdType |
NotApplicable |
||
| StartDate |
|
||
Data Aggregation Medical Claim Load
| PrescribingProviderId |
NULL |
||||
| PrescribingProviderIdType |
"NotApplicable" |
||||
| StartDate |
|
||||
|
Minimum of STMT_COV_FROM_DATE - Time Zone: Unspecified and SERVICE_START_DATE - Time Zone: Unspecified |
Data Aggregation Pharmacy Claim Load
| PrescribingProviderId |
|
||||||
|
If PROV_IDENT_QUAL = "01" and PROV_IDENT is not NULL then PROV_IDENT Otherwise PRESC_PROV_ID |
|||||||
| PrescribingProviderIdType |
|
||||||
|
If PROV_IDENT_QUAL = "01" and PROV_IDENT is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId" |
|||||||
| StartDate |
|
||||||
Externally Adjudicated Medical Claim Load
| PrescribingProviderId |
NULL |
||||
| PrescribingProviderIdType |
"NotApplicable" |
||||
| StartDate |
|
||||
|
Minimum of STMT_COV_FROM_DATE - Time Zone: Unspecified and SERVICE_START_DATE - Time Zone: Unspecified |
Externally Adjudicated Pharmacy Claim Load
| PrescribingProviderId |
|
||||||
|
If PROV_IDENT_QUAL = "01" and PROV_IDENT is not NULL then PROV_IDENT Otherwise PRESC_PROV_ID |
|||||||
| PrescribingProviderIdType |
|
||||||
|
If PROV_IDENT_QUAL = "01" and PROV_IDENT is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId" |
|||||||
| StartDate |
|
||||||
Payer System Medical Claim Load
| PrescribingProviderId |
NULL |
||||
| PrescribingProviderIdType |
"NotApplicable" |
||||
| StartDate |
|
||||
|
Minimum of STMT_COV_FROM_DATE - Time Zone: Unspecified and SERVICE_START_DATE - Time Zone: Unspecified |
Payer System Pharmacy Claim Load
| PrescribingProviderId |
|
||||||
|
If PROV_IDENT_QUAL = "01" and PROV_IDENT is not NULL then PROV_IDENT Otherwise PRESC_PROV_ID |
|||||||
| PrescribingProviderIdType |
|
||||||
|
If PROV_IDENT_QUAL = "01" and PROV_IDENT is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId" |
|||||||
| StartDate |
|
||||||
Received Claim Load
| PrescribingProviderId |
NULL |
||||
| PrescribingProviderIdType |
"NotApplicable" |
||||
| StartDate |
|
||||
|
Minimum of STMT_COV_FROM_DATE - Time Zone: Unspecified and SERVICE_START_DATE - Time Zone: Unspecified |
Received Pharmacy Claim Load
| PrescribingProviderId |
|
||||||
|
If PROV_IDENT_QUAL = "01" and PROV_IDENT is not NULL then PROV_IDENT Otherwise PRESC_PROV_ID |
|||||||
| PrescribingProviderIdType |
|
||||||
|
If PROV_IDENT_QUAL = "01" and PROV_IDENT is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId" |
|||||||
| StartDate |
|
||||||
PrescribingProviderDurableKey
: integerProvider who prescribed the medication
Properties
- Data type
- integer
- SQL Server data type
- bigint
- Allows null
- No
- Default value
- -1
- Delete value
- -3
Data Lineage for Each Package
CMS ACO Part A Files Load
| PrescribingProviderId |
NULL |
| PrescribingProviderIdType |
"NotApplicable" |
CMS ACO Part B DME File Load
| PrescribingProviderId |
NULL |
| PrescribingProviderIdType |
"NotApplicable" |
CMS ACO Part B Physicians File Load
| PrescribingProviderId |
NULL |
| PrescribingProviderIdType |
"NotApplicable" |
CMS ACO Part D Prescription Drug File Load
| PrescribingProviderId |
|
||||
|
If PRVDR_PRSBNG_ID_QLFYR_CD = 01-NPI Number then CLM_PRSBNG_PRVDR_GNRC_ID_NUM |
|||||
| PrescribingProviderIdType |
"EpicProviderNpi" |
CMS CJR DME Claim Load
| PrescribingProviderId |
NULL |
| PrescribingProviderIdType |
NotApplicable |
CMS CJR Home Health Claim Load
| PrescribingProviderId |
NULL |
| PrescribingProviderIdType |
NotApplicable |
CMS CJR Hospice Claim Load
| PrescribingProviderId |
NULL |
| PrescribingProviderIdType |
NotApplicable |
CMS CJR Inpatient Claim Load
| PrescribingProviderId |
NULL |
| PrescribingProviderIdType |
NotApplicable |
CMS CJR Outpatient Claim Load
| PrescribingProviderId |
NULL |
| PrescribingProviderIdType |
NotApplicable |
CMS CJR Part B Claim Load
| PrescribingProviderId |
NULL |
| PrescribingProviderIdType |
NotApplicable |
CMS CJR Skilled Nursing Facility Claim Load
| PrescribingProviderId |
NULL |
| PrescribingProviderIdType |
NotApplicable |
Data Aggregation Medical Claim Load
| PrescribingProviderId |
NULL |
| PrescribingProviderIdType |
"NotApplicable" |
Data Aggregation Pharmacy Claim Load
| PrescribingProviderId |
|
||||||
|
If PROV_IDENT_QUAL = "01" and PROV_IDENT is not NULL then PROV_IDENT Otherwise PRESC_PROV_ID |
|||||||
| PrescribingProviderIdType |
|
||||||
|
If PROV_IDENT_QUAL = "01" and PROV_IDENT is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId" |
Externally Adjudicated Medical Claim Load
| PrescribingProviderId |
NULL |
| PrescribingProviderIdType |
"NotApplicable" |
Externally Adjudicated Pharmacy Claim Load
| PrescribingProviderId |
|
||||||
|
If PROV_IDENT_QUAL = "01" and PROV_IDENT is not NULL then PROV_IDENT Otherwise PRESC_PROV_ID |
|||||||
| PrescribingProviderIdType |
|
||||||
|
If PROV_IDENT_QUAL = "01" and PROV_IDENT is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId" |
Payer System Medical Claim Load
| PrescribingProviderId |
NULL |
| PrescribingProviderIdType |
"NotApplicable" |
Payer System Pharmacy Claim Load
| PrescribingProviderId |
|
||||||
|
If PROV_IDENT_QUAL = "01" and PROV_IDENT is not NULL then PROV_IDENT Otherwise PRESC_PROV_ID |
|||||||
| PrescribingProviderIdType |
|
||||||
|
If PROV_IDENT_QUAL = "01" and PROV_IDENT is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId" |
Received Claim Load
| PrescribingProviderId |
NULL |
| PrescribingProviderIdType |
"NotApplicable" |
Received Pharmacy Claim Load
| PrescribingProviderId |
|
||||||
|
If PROV_IDENT_QUAL = "01" and PROV_IDENT is not NULL then PROV_IDENT Otherwise PRESC_PROV_ID |
|||||||
| PrescribingProviderIdType |
|
||||||
|
If PROV_IDENT_QUAL = "01" and PROV_IDENT is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId" |
PrescribingProviderSourceDataDurableKey
: integerProvider who prescribed the medication
Properties
- Data type
- integer
- SQL Server data type
- bigint
- Allows null
- No
- Default value
- -1
- Delete value
- -3
Data Lineage for Each Package
CMS ACO Part A Files Load
| PrescribingProviderId |
NULL |
| PrescribingProviderIdType |
"NotApplicable" |
| PrescribingProviderSourceName |
NULL |
CMS ACO Part B DME File Load
| PrescribingProviderId |
NULL |
| PrescribingProviderIdType |
"NotApplicable" |
| PrescribingProviderSourceName |
NULL |
CMS ACO Part B Physicians File Load
| PrescribingProviderId |
NULL |
| PrescribingProviderIdType |
"NotApplicable" |
| PrescribingProviderSourceName |
NULL |
CMS ACO Part D Prescription Drug File Load
| PrescribingProviderId |
|
||||
|
If PRVDR_PRSBNG_ID_QLFYR_CD = 01-NPI Number then CLM_PRSBNG_PRVDR_GNRC_ID_NUM |
|||||
| PrescribingProviderIdType |
"EpicProviderNpi" |
||||
| PrescribingProviderSourceName |
"NPPES" |
CMS CJR DME Claim Load
| PrescribingProviderId |
NULL |
| PrescribingProviderIdType |
NotApplicable |
| PrescribingProviderSourceName |
NULL |
CMS CJR Home Health Claim Load
| PrescribingProviderId |
NULL |
| PrescribingProviderIdType |
NotApplicable |
| PrescribingProviderSourceName |
NULL |
CMS CJR Hospice Claim Load
| PrescribingProviderId |
NULL |
| PrescribingProviderIdType |
NotApplicable |
| PrescribingProviderSourceName |
NULL |
CMS CJR Inpatient Claim Load
| PrescribingProviderId |
NULL |
| PrescribingProviderIdType |
NotApplicable |
| PrescribingProviderSourceName |
NULL |
CMS CJR Outpatient Claim Load
| PrescribingProviderId |
NULL |
| PrescribingProviderIdType |
NotApplicable |
| PrescribingProviderSourceName |
NULL |
CMS CJR Part B Claim Load
| PrescribingProviderId |
NULL |
| PrescribingProviderIdType |
NotApplicable |
| PrescribingProviderSourceName |
NULL |
CMS CJR Skilled Nursing Facility Claim Load
| PrescribingProviderId |
NULL |
| PrescribingProviderIdType |
NotApplicable |
| PrescribingProviderSourceName |
NULL |
Data Aggregation Medical Claim Load
| PrescribingProviderId |
NULL |
| PrescribingProviderIdType |
"NotApplicable" |
| PrescribingProviderSourceName |
NULL |
Data Aggregation Pharmacy Claim Load
| PrescribingProviderId |
|
||||||
|
If PROV_IDENT_QUAL = "01" and PROV_IDENT is not NULL then PROV_IDENT Otherwise PRESC_PROV_ID |
|||||||
| PrescribingProviderIdType |
|
||||||
|
If PROV_IDENT_QUAL = "01" and PROV_IDENT is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId" |
|||||||
| PrescribingProviderSourceName |
|
||||||
|
If PROV_IDENT_QUAL = "01" and PROV_IDENT is not NULL then "NPPES" Otherwise NULL (use source of the package) |
Externally Adjudicated Medical Claim Load
| PrescribingProviderId |
NULL |
| PrescribingProviderIdType |
"NotApplicable" |
| PrescribingProviderSourceName |
NULL |
Externally Adjudicated Pharmacy Claim Load
| PrescribingProviderId |
|
||||||
|
If PROV_IDENT_QUAL = "01" and PROV_IDENT is not NULL then PROV_IDENT Otherwise PRESC_PROV_ID |
|||||||
| PrescribingProviderIdType |
|
||||||
|
If PROV_IDENT_QUAL = "01" and PROV_IDENT is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId" |
|||||||
| PrescribingProviderSourceName |
|
||||||
|
If PROV_IDENT_QUAL = "01" and PROV_IDENT is not NULL then "NPPES" Otherwise NULL (use source of the package) |
Payer System Medical Claim Load
| PrescribingProviderId |
NULL |
| PrescribingProviderIdType |
"NotApplicable" |
| PrescribingProviderSourceName |
NULL |
Payer System Pharmacy Claim Load
| PrescribingProviderId |
|
||||||
|
If PROV_IDENT_QUAL = "01" and PROV_IDENT is not NULL then PROV_IDENT Otherwise PRESC_PROV_ID |
|||||||
| PrescribingProviderIdType |
|
||||||
|
If PROV_IDENT_QUAL = "01" and PROV_IDENT is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId" |
|||||||
| PrescribingProviderSourceName |
|
||||||
|
If PROV_IDENT_QUAL = "01" and PROV_IDENT is not NULL then "NPPES" Otherwise NULL (use source of the package) |
Received Claim Load
| PrescribingProviderId |
NULL |
| PrescribingProviderIdType |
"NotApplicable" |
| PrescribingProviderSourceName |
NULL |
Received Pharmacy Claim Load
| PrescribingProviderId |
|
||||||
|
If PROV_IDENT_QUAL = "01" and PROV_IDENT is not NULL then PROV_IDENT Otherwise PRESC_PROV_ID |
|||||||
| PrescribingProviderIdType |
|
||||||
|
If PROV_IDENT_QUAL = "01" and PROV_IDENT is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId" |
|||||||
| PrescribingProviderSourceName |
|
||||||
|
If PROV_IDENT_QUAL = "01" and PROV_IDENT is not NULL then "NPPES" Otherwise NULL (use source of the package) |
ServiceProviderKey
: integerProvider who was responsible for the pharmacy service
Properties
- Data type
- integer
- SQL Server data type
- bigint
- Allows null
- No
- Default value
- -1
- Delete value
- -3
Data Lineage for Each Package
CMS ACO Part A Files Load
| ServiceProviderId |
NULL |
||
| ServiceProviderIdType |
"NotApplicable" |
||
| StartDate |
|
||
|
If CLM_FROM_DT < 1/1/1753 or CLM_FROM_DT = 12/31/9999 then NULL Otherwise CLM_FROM_DT |
CMS ACO Part B DME File Load
| ServiceProviderId |
NULL |
||
| ServiceProviderIdType |
"NotApplicable" |
||
| StartDate |
|
||
|
If CLM_FROM_DT < 1/1/1753 or CLM_FROM_DT = 12/31/9999 then NULL Otherwise CLM_FROM_DT |
CMS ACO Part B Physicians File Load
| ServiceProviderId |
NULL |
||
| ServiceProviderIdType |
"NotApplicable" |
||
| StartDate |
|
||
|
If CLM_FROM_DT < 1/1/1753 or CLM_FROM_DT = 12/31/9999 then NULL Otherwise CLM_FROM_DT |
CMS ACO Part D Prescription Drug File Load
| ServiceProviderId |
|
||||
|
If PRVDR_SRVC_ID_QLFYR_CD = 01-NPI Number then CLM_SRVC_PRVDR_GNRC_ID_NUM |
|||||
| ServiceProviderIdType |
"EpicProviderNpi" |
||||
| StartDate |
|
||||
|
If CLM_LINE_FROM_DT < 1/1/1753 or CLM_LINE_FROM_DT = 12/31/9999 then NULL Otherwise CLM_LINE_FROM_DT |
CMS CJR DME Claim Load
| ServiceProviderId |
NULL |
||
| ServiceProviderIdType |
NotApplicable |
||
| StartDate |
|
||
CMS CJR Home Health Claim Load
| ServiceProviderId |
NULL |
||
| ServiceProviderIdType |
NotApplicable |
||
| StartDate |
|
||
CMS CJR Hospice Claim Load
| ServiceProviderId |
NULL |
||
| ServiceProviderIdType |
NotApplicable |
||
| StartDate |
|
||
CMS CJR Inpatient Claim Load
| ServiceProviderId |
NULL |
||
| ServiceProviderIdType |
NotApplicable |
||
| StartDate |
|
||
CMS CJR Outpatient Claim Load
| ServiceProviderId |
NULL |
||
| ServiceProviderIdType |
NotApplicable |
||
| StartDate |
|
||
CMS CJR Part B Claim Load
| ServiceProviderId |
NULL |
||
| ServiceProviderIdType |
NotApplicable |
||
| StartDate |
|
||
CMS CJR Skilled Nursing Facility Claim Load
| ServiceProviderId |
NULL |
||
| ServiceProviderIdType |
NotApplicable |
||
| StartDate |
|
||
Data Aggregation Medical Claim Load
| ServiceProviderId |
NULL |
||||
| ServiceProviderIdType |
"NotApplicable" |
||||
| StartDate |
|
||||
|
Minimum of STMT_COV_FROM_DATE - Time Zone: Unspecified and SERVICE_START_DATE - Time Zone: Unspecified |
Data Aggregation Pharmacy Claim Load
| ServiceProviderId |
|
||||
|
If SVC_PROV_IDENT_QUAL = "01" and SVC_PROV_IDENT is not NULL then SVC_PROV_IDENT Otherwise NULL |
|||||
| ServiceProviderIdType |
|
||||
|
If SVC_PROV_IDENT_QUAL = "01" and SVC_PROV_IDENT is not NULL then "EpicProviderNpi" Otherwise "Unspecified" |
|||||
| StartDate |
|
||||
Externally Adjudicated Medical Claim Load
| ServiceProviderId |
NULL |
||||
| ServiceProviderIdType |
"NotApplicable" |
||||
| StartDate |
|
||||
|
Minimum of STMT_COV_FROM_DATE - Time Zone: Unspecified and SERVICE_START_DATE - Time Zone: Unspecified |
Externally Adjudicated Pharmacy Claim Load
| ServiceProviderId |
|
||||
|
If SVC_PROV_IDENT_QUAL = "01" and SVC_PROV_IDENT is not NULL then SVC_PROV_IDENT Otherwise NULL |
|||||
| ServiceProviderIdType |
|
||||
|
If SVC_PROV_IDENT_QUAL = "01" and SVC_PROV_IDENT is not NULL then "EpicProviderNpi" Otherwise "Unspecified" |
|||||
| StartDate |
|
||||
Payer System Medical Claim Load
| ServiceProviderId |
NULL |
||||
| ServiceProviderIdType |
"NotApplicable" |
||||
| StartDate |
|
||||
|
Minimum of STMT_COV_FROM_DATE - Time Zone: Unspecified and SERVICE_START_DATE - Time Zone: Unspecified |
Payer System Pharmacy Claim Load
| ServiceProviderId |
|
||||
|
If SVC_PROV_IDENT_QUAL = "01" and SVC_PROV_IDENT is not NULL then SVC_PROV_IDENT Otherwise NULL |
|||||
| ServiceProviderIdType |
|
||||
|
If SVC_PROV_IDENT_QUAL = "01" and SVC_PROV_IDENT is not NULL then "EpicProviderNpi" Otherwise "Unspecified" |
|||||
| StartDate |
|
||||
Received Claim Load
| ServiceProviderId |
NULL |
||||
| ServiceProviderIdType |
"NotApplicable" |
||||
| StartDate |
|
||||
|
Minimum of STMT_COV_FROM_DATE - Time Zone: Unspecified and SERVICE_START_DATE - Time Zone: Unspecified |
Received Pharmacy Claim Load
| ServiceProviderId |
|
||||
|
If SVC_PROV_IDENT_QUAL = "01" and SVC_PROV_IDENT is not NULL then SVC_PROV_IDENT Otherwise NULL |
|||||
| ServiceProviderIdType |
|
||||
|
If SVC_PROV_IDENT_QUAL = "01" and SVC_PROV_IDENT is not NULL then "EpicProviderNpi" Otherwise "Unspecified" |
|||||
| StartDate |
|
||||
ServiceProviderDurableKey
: integerProvider who was responsible for the pharmacy service
Properties
- Data type
- integer
- SQL Server data type
- bigint
- Allows null
- No
- Default value
- -1
- Delete value
- -3
Data Lineage for Each Package
CMS ACO Part A Files Load
| ServiceProviderId |
NULL |
| ServiceProviderIdType |
"NotApplicable" |
CMS ACO Part B DME File Load
| ServiceProviderId |
NULL |
| ServiceProviderIdType |
"NotApplicable" |
CMS ACO Part B Physicians File Load
| ServiceProviderId |
NULL |
| ServiceProviderIdType |
"NotApplicable" |
CMS ACO Part D Prescription Drug File Load
| ServiceProviderId |
|
||||
|
If PRVDR_SRVC_ID_QLFYR_CD = 01-NPI Number then CLM_SRVC_PRVDR_GNRC_ID_NUM |
|||||
| ServiceProviderIdType |
"EpicProviderNpi" |
CMS CJR DME Claim Load
| ServiceProviderId |
NULL |
| ServiceProviderIdType |
NotApplicable |
CMS CJR Home Health Claim Load
| ServiceProviderId |
NULL |
| ServiceProviderIdType |
NotApplicable |
CMS CJR Hospice Claim Load
| ServiceProviderId |
NULL |
| ServiceProviderIdType |
NotApplicable |
CMS CJR Inpatient Claim Load
| ServiceProviderId |
NULL |
| ServiceProviderIdType |
NotApplicable |
CMS CJR Outpatient Claim Load
| ServiceProviderId |
NULL |
| ServiceProviderIdType |
NotApplicable |
CMS CJR Part B Claim Load
| ServiceProviderId |
NULL |
| ServiceProviderIdType |
NotApplicable |
CMS CJR Skilled Nursing Facility Claim Load
| ServiceProviderId |
NULL |
| ServiceProviderIdType |
NotApplicable |
Data Aggregation Medical Claim Load
| ServiceProviderId |
NULL |
| ServiceProviderIdType |
"NotApplicable" |
Data Aggregation Pharmacy Claim Load
| ServiceProviderId |
|
||||
|
If SVC_PROV_IDENT_QUAL = "01" and SVC_PROV_IDENT is not NULL then SVC_PROV_IDENT Otherwise NULL |
|||||
| ServiceProviderIdType |
|
||||
|
If SVC_PROV_IDENT_QUAL = "01" and SVC_PROV_IDENT is not NULL then "EpicProviderNpi" Otherwise "Unspecified" |
Externally Adjudicated Medical Claim Load
| ServiceProviderId |
NULL |
| ServiceProviderIdType |
"NotApplicable" |
Externally Adjudicated Pharmacy Claim Load
| ServiceProviderId |
|
||||
|
If SVC_PROV_IDENT_QUAL = "01" and SVC_PROV_IDENT is not NULL then SVC_PROV_IDENT Otherwise NULL |
|||||
| ServiceProviderIdType |
|
||||
|
If SVC_PROV_IDENT_QUAL = "01" and SVC_PROV_IDENT is not NULL then "EpicProviderNpi" Otherwise "Unspecified" |
Payer System Medical Claim Load
| ServiceProviderId |
NULL |
| ServiceProviderIdType |
"NotApplicable" |
Payer System Pharmacy Claim Load
| ServiceProviderId |
|
||||
|
If SVC_PROV_IDENT_QUAL = "01" and SVC_PROV_IDENT is not NULL then SVC_PROV_IDENT Otherwise NULL |
|||||
| ServiceProviderIdType |
|
||||
|
If SVC_PROV_IDENT_QUAL = "01" and SVC_PROV_IDENT is not NULL then "EpicProviderNpi" Otherwise "Unspecified" |
Received Claim Load
| ServiceProviderId |
NULL |
| ServiceProviderIdType |
"NotApplicable" |
Received Pharmacy Claim Load
| ServiceProviderId |
|
||||
|
If SVC_PROV_IDENT_QUAL = "01" and SVC_PROV_IDENT is not NULL then SVC_PROV_IDENT Otherwise NULL |
|||||
| ServiceProviderIdType |
|
||||
|
If SVC_PROV_IDENT_QUAL = "01" and SVC_PROV_IDENT is not NULL then "EpicProviderNpi" Otherwise "Unspecified" |
ServiceProviderSourceDataDurableKey
: integerProvider who was responsible for the pharmacy service
Properties
- Data type
- integer
- SQL Server data type
- bigint
- Allows null
- No
- Default value
- -1
- Delete value
- -3
Data Lineage for Each Package
CMS ACO Part A Files Load
| ServiceProviderId |
NULL |
| ServiceProviderIdType |
"NotApplicable" |
| ServiceProviderSourceName |
NULL |
CMS ACO Part B DME File Load
| ServiceProviderId |
NULL |
| ServiceProviderIdType |
"NotApplicable" |
| ServiceProviderSourceName |
NULL |
CMS ACO Part B Physicians File Load
| ServiceProviderId |
NULL |
| ServiceProviderIdType |
"NotApplicable" |
| ServiceProviderSourceName |
NULL |
CMS ACO Part D Prescription Drug File Load
| ServiceProviderId |
|
||||
|
If PRVDR_SRVC_ID_QLFYR_CD = 01-NPI Number then CLM_SRVC_PRVDR_GNRC_ID_NUM |
|||||
| ServiceProviderIdType |
"EpicProviderNpi" |
||||
| ServiceProviderSourceName |
"NPPES" |
CMS CJR DME Claim Load
| ServiceProviderId |
NULL |
| ServiceProviderIdType |
NotApplicable |
| ServiceProviderSourceName |
NULL |
CMS CJR Home Health Claim Load
| ServiceProviderId |
NULL |
| ServiceProviderIdType |
NotApplicable |
| ServiceProviderSourceName |
NULL |
CMS CJR Hospice Claim Load
| ServiceProviderId |
NULL |
| ServiceProviderIdType |
NotApplicable |
| ServiceProviderSourceName |
NULL |
CMS CJR Inpatient Claim Load
| ServiceProviderId |
NULL |
| ServiceProviderIdType |
NotApplicable |
| ServiceProviderSourceName |
NULL |
CMS CJR Outpatient Claim Load
| ServiceProviderId |
NULL |
| ServiceProviderIdType |
NotApplicable |
| ServiceProviderSourceName |
NULL |
CMS CJR Part B Claim Load
| ServiceProviderId |
NULL |
| ServiceProviderIdType |
NotApplicable |
| ServiceProviderSourceName |
NULL |
CMS CJR Skilled Nursing Facility Claim Load
| ServiceProviderId |
NULL |
| ServiceProviderIdType |
NotApplicable |
| ServiceProviderSourceName |
NULL |
Data Aggregation Medical Claim Load
| ServiceProviderId |
NULL |
| ServiceProviderIdType |
"NotApplicable" |
| ServiceProviderSourceName |
NULL |
Data Aggregation Pharmacy Claim Load
| ServiceProviderId |
|
||||
|
If SVC_PROV_IDENT_QUAL = "01" and SVC_PROV_IDENT is not NULL then SVC_PROV_IDENT Otherwise NULL |
|||||
| ServiceProviderIdType |
|
||||
|
If SVC_PROV_IDENT_QUAL = "01" and SVC_PROV_IDENT is not NULL then "EpicProviderNpi" Otherwise "Unspecified" |
|||||
| ServiceProviderSourceName |
"NPPES" |
Externally Adjudicated Medical Claim Load
| ServiceProviderId |
NULL |
| ServiceProviderIdType |
"NotApplicable" |
| ServiceProviderSourceName |
NULL |
Externally Adjudicated Pharmacy Claim Load
| ServiceProviderId |
|
||||
|
If SVC_PROV_IDENT_QUAL = "01" and SVC_PROV_IDENT is not NULL then SVC_PROV_IDENT Otherwise NULL |
|||||
| ServiceProviderIdType |
|
||||
|
If SVC_PROV_IDENT_QUAL = "01" and SVC_PROV_IDENT is not NULL then "EpicProviderNpi" Otherwise "Unspecified" |
|||||
| ServiceProviderSourceName |
"NPPES" |
Payer System Medical Claim Load
| ServiceProviderId |
NULL |
| ServiceProviderIdType |
"NotApplicable" |
| ServiceProviderSourceName |
NULL |
Payer System Pharmacy Claim Load
| ServiceProviderId |
|
||||
|
If SVC_PROV_IDENT_QUAL = "01" and SVC_PROV_IDENT is not NULL then SVC_PROV_IDENT Otherwise NULL |
|||||
| ServiceProviderIdType |
|
||||
|
If SVC_PROV_IDENT_QUAL = "01" and SVC_PROV_IDENT is not NULL then "EpicProviderNpi" Otherwise "Unspecified" |
|||||
| ServiceProviderSourceName |
"NPPES" |
Received Claim Load
| ServiceProviderId |
NULL |
| ServiceProviderIdType |
"NotApplicable" |
| ServiceProviderSourceName |
NULL |
Received Pharmacy Claim Load
| ServiceProviderId |
|
||||
|
If SVC_PROV_IDENT_QUAL = "01" and SVC_PROV_IDENT is not NULL then SVC_PROV_IDENT Otherwise NULL |
|||||
| ServiceProviderIdType |
|
||||
|
If SVC_PROV_IDENT_QUAL = "01" and SVC_PROV_IDENT is not NULL then "EpicProviderNpi" Otherwise "Unspecified" |
|||||
| ServiceProviderSourceName |
"NPPES" |
DrgKey
: integerDiagnosis Related Group (DRG) associated with the claim
Properties
- Data type
- integer
- SQL Server data type
- bigint
- Allows null
- No
- Default value
- -1
- Delete value
- -3
Data Lineage for Each Package
CMS ACO Part A Files Load
| DrgId |
This column isn't configured for use in reports. See an administrator for more information |
| DrgIdType |
This column isn't configured for use in reports. See an administrator for more information |
CMS ACO Part B DME File Load
| DrgId |
NULL |
| DrgIdType |
"NotApplicable" |
CMS ACO Part B Physicians File Load
| DrgId |
NULL |
| DrgIdType |
"NotApplicable" |
CMS ACO Part D Prescription Drug File Load
| DrgId |
NULL |
| DrgIdType |
"NotApplicable" |
CMS CJR DME Claim Load
| DrgId |
NULL |
| DrgIdType |
NotApplicable |
CMS CJR Home Health Claim Load
| DrgId |
NULL |
| DrgIdType |
NotApplicable |
CMS CJR Hospice Claim Load
| DrgId |
NULL |
| DrgIdType |
NotApplicable |
CMS CJR Inpatient Claim Load
| DrgId |
|
||||
|
This column isn't configured for use in reports. See an administrator for more information. |
|||||
| DrgIdType |
This column isn't configured for use in reports. See an administrator for more information. |
CMS CJR Outpatient Claim Load
| DrgId |
NULL |
| DrgIdType |
NotApplicable |
CMS CJR Part B Claim Load
| DrgId |
NULL |
| DrgIdType |
NotApplicable |
CMS CJR Skilled Nursing Facility Claim Load
| DrgId |
|
||||
|
This column isn't configured for use in reports. See an administrator for more information. |
|||||
| DrgIdType |
This column isn't configured for use in reports. See an administrator for more information. |
Data Aggregation Medical Claim Load
| DrgId |
|
||||
|
If DRG_ID_TYPE_ID is not NULL then DRG_ID_TYPE_ID + "|" + DRG_ID Otherwise DRG_ID |
|||||
| DrgIdType |
|
||||
|
If DRG_ID_TYPE_ID is not NULL then "EpicIdentityId|DrgId" Otherwise "EpicDrgId" |
Data Aggregation Pharmacy Claim Load
| DrgId | |
| DrgIdType |
"NotApplicable" |
Externally Adjudicated Medical Claim Load
| DrgId |
|
||||
|
If DRG_ID_TYPE_ID is not NULL then DRG_ID_TYPE_ID + "|" + DRG_ID Otherwise DRG_ID |
|||||
| DrgIdType |
|
||||
|
If DRG_ID_TYPE_ID is not NULL then "EpicIdentityId|DrgId" Otherwise "EpicDrgId" |
Externally Adjudicated Pharmacy Claim Load
| DrgId | |
| DrgIdType |
"NotApplicable" |
Payer System Medical Claim Load
| DrgId |
|
||||
|
If DRG_ID_TYPE_ID is not NULL then DRG_ID_TYPE_ID + "|" + DRG_ID Otherwise DRG_ID |
|||||
| DrgIdType |
|
||||
|
If DRG_ID_TYPE_ID is not NULL then "EpicIdentityId|DrgId" Otherwise "EpicDrgId" |
Payer System Pharmacy Claim Load
| DrgId | |
| DrgIdType |
"NotApplicable" |
Received Claim Load
| DrgId |
|
||||
|
If DRG_ID_TYPE_ID is not NULL then DRG_ID_TYPE_ID + "|" + DRG_ID Otherwise DRG_ID |
|||||
| DrgIdType |
|
||||
|
If DRG_ID_TYPE_ID is not NULL then "EpicIdentityId|DrgId" Otherwise "EpicDrgId" |
Received Pharmacy Claim Load
| DrgId | |
| DrgIdType |
"NotApplicable" |
PrimaryDiagnosisKey
: integerPrimary claim diagnosis
Properties
- Data type
- integer
- SQL Server data type
- bigint
- Allows null
- No
- Default value
- -1
- Delete value
- -3
Data Lineage for Each Package
CMS ACO Part A Files Load
| PrimaryDiagnosisId |
|
||||
| PrimaryDiagnosisIdType |
|
||||
|
If DGNS_PRCDR_ICD_IND = 9-ICD 9 or FileGenerationDate < 2015-11-1 then "ICD-9-CM" Otherwise if DGNS_PRCDR_ICD_IND = 0-ICD 10 and FileGenerationDate >= 2015-11-1 then "ICD-10-CM" Otherwise "NotApplicable" |
CMS ACO Part B DME File Load
| PrimaryDiagnosisId |
NULL |
| PrimaryDiagnosisIdType |
"NotApplicable" |
CMS ACO Part B Physicians File Load
| PrimaryDiagnosisId |
|
||||
| PrimaryDiagnosisIdType |
|
||||
|
If DGNS_PRCDR_ICD_IND = 9-ICD 9 or FileGenerationDate < 2015-11-1 then "ICD-9-CM" Otherwise if DGNS_PRCDR_ICD_IND = 0-ICD 10 and MsspPartBPhysicians.FileGenerationDate >= 2015-11-1 then "ICD-10-CM" Otherwise "NotApplicable" |
CMS ACO Part D Prescription Drug File Load
| PrimaryDiagnosisId |
NULL |
| PrimaryDiagnosisIdType |
"NotApplicable" |
CMS CJR DME Claim Load
| PrimaryDiagnosisId |
|
||||
| PrimaryDiagnosisIdType |
|
||||
|
If DGNS_PRCDR_ICD_IND = 9-ICD-9 or CLM_THRU_DT < 2015-10-01 then ICD-9-CM Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and CLM_THRU_DT >= 2015-10-01 then ICD-10-CM Otherwise Unspecified |
CMS CJR Home Health Claim Load
| PrimaryDiagnosisId |
|
||||
| PrimaryDiagnosisIdType |
|
||||
|
If DGNS_PRCDR_ICD_IND = 9-ICD-9 or CLM_THRU_DT < 2015-10-01 then ICD-9-CM Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and CLM_THRU_DT >= 2015-10-01 then ICD-10-CM Otherwise Unspecified |
CMS CJR Hospice Claim Load
| PrimaryDiagnosisId |
|
||||
| PrimaryDiagnosisIdType |
|
||||
|
If DGNS_PRCDR_ICD_IND = 9-ICD-9 or CLM_THRU_DT < 2015-10-01 then ICD-9-CM Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and CLM_THRU_DT >= 2015-10-01 then ICD-10-CM Otherwise Unspecified |
CMS CJR Inpatient Claim Load
| PrimaryDiagnosisId |
|
||||||
| PrimaryDiagnosisIdType |
|
||||||
|
If DGNS_PRCDR_ICD_IND = 9-ICD-9 or DSCHRGDT < 2015-10-01 or ( DSCHRGDT is NULL and CLM_THRU_DT < 2015-10-01 ) then ICD-9-CM Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and ( DSCHRGDT >= 2015-10-01 or ( DSCHRGDT is NULL and CLM_THRU_DT >= 2015-10-01 ) ) then ICD-10-CM Otherwise Unspecified |
CMS CJR Outpatient Claim Load
| PrimaryDiagnosisId |
|
||||
| PrimaryDiagnosisIdType |
|
||||
|
If DGNS_PRCDR_ICD_IND = 9-ICD-9 or CLM_THRU_DT < 2015-10-01 then ICD-9-CM Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and CLM_THRU_DT >= 2015-10-01 then ICD-10-CM Otherwise Unspecified |
CMS CJR Part B Claim Load
| PrimaryDiagnosisId |
|
||||
| PrimaryDiagnosisIdType |
|
||||
|
If DGNS_PRCDR_ICD_IND = 9-ICD-9 or CLM_THRU_DT < 2015-10-01 then ICD-9-CM Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and CLM_THRU_DT >= 2015-10-01 then ICD-10-CM Otherwise Unspecified |
CMS CJR Skilled Nursing Facility Claim Load
| PrimaryDiagnosisId |
|
||||||
| PrimaryDiagnosisIdType |
|
||||||
|
If DGNS_PRCDR_ICD_IND = 9-ICD-9 or DSCHRGDT < 2015-10-01 or ( DSCHRGDT is NULL and CLM_THRU_DT < 2015-10-01 ) then ICD-9-CM Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and ( DSCHRGDT >= 2015-10-01 or ( DSCHRGDT is NULL and CLM_THRU_DT >= 2015-10-01 ) ) then ICD-10-CM Otherwise Unspecified |
Data Aggregation Medical Claim Load
| PrimaryDiagnosisId |
|
||||
| PrimaryDiagnosisIdType |
|
||||
|
If FIRSTDXID is not NULL then "EpicDiagnosisId" Otherwise "NotApplicable" |
Data Aggregation Pharmacy Claim Load
| PrimaryDiagnosisId |
|
||||
| PrimaryDiagnosisIdType |
"EpicDiagnosisId" |
Externally Adjudicated Medical Claim Load
| PrimaryDiagnosisId |
NULL |
| PrimaryDiagnosisIdType |
"Unspecified" |
Externally Adjudicated Pharmacy Claim Load
| PrimaryDiagnosisId | |
| PrimaryDiagnosisIdType |
"NotApplicable" |
Payer System Medical Claim Load
| PrimaryDiagnosisId |
|
||||
| PrimaryDiagnosisIdType |
|
||||
|
If FIRSTDXID is not NULL then "EpicDiagnosisId" Otherwise "NotApplicable" |
Payer System Pharmacy Claim Load
| PrimaryDiagnosisId | |
| PrimaryDiagnosisIdType |
"NotApplicable" |
Received Claim Load
| PrimaryDiagnosisId |
|
||||
|
DX_ID where LINE = 1 |
|||||
| PrimaryDiagnosisIdType |
"EpicDiagnosisId" |
Received Pharmacy Claim Load
| PrimaryDiagnosisId | |
| PrimaryDiagnosisIdType |
"NotApplicable" |
AdmittingDiagnosisKey
: integerClaim diagnosis for which the beneficiary was admitted
Properties
- Data type
- integer
- SQL Server data type
- bigint
- Allows null
- No
- Default value
- -1
- Delete value
- -3
Data Lineage for Each Package
CMS ACO Part A Files Load
| AdmittingDiagnosisId |
|
||||
| AdmittingDiagnosisIdType |
|
||||
|
If DGNS_PRCDR_ICD_IND = 9-ICD 9 or FileGenerationDate < 2015-11-1 then "ICD-9-CM" Otherwise if DGNS_PRCDR_ICD_IND = 0-ICD 10 and FileGenerationDate >= 2015-11-1 then "ICD-10-CM" Otherwise "NotApplicable" |
CMS ACO Part B DME File Load
| AdmittingDiagnosisId |
NULL |
| AdmittingDiagnosisIdType |
"NotApplicable" |
CMS ACO Part B Physicians File Load
| AdmittingDiagnosisId |
NULL |
| AdmittingDiagnosisIdType |
"NotApplicable" |
CMS ACO Part D Prescription Drug File Load
| AdmittingDiagnosisId |
NULL |
| AdmittingDiagnosisIdType |
"NotApplicable" |
CMS CJR DME Claim Load
| AdmittingDiagnosisId |
NULL |
| AdmittingDiagnosisIdType |
NotApplicable |
CMS CJR Home Health Claim Load
| AdmittingDiagnosisId |
NULL |
| AdmittingDiagnosisIdType |
NotApplicable |
CMS CJR Hospice Claim Load
| AdmittingDiagnosisId |
NULL |
| AdmittingDiagnosisIdType |
NotApplicable |
CMS CJR Inpatient Claim Load
| AdmittingDiagnosisId |
|
||||||
| AdmittingDiagnosisIdType |
|
||||||
|
If DGNS_PRCDR_ICD_IND = 9-ICD-9 or DSCHRGDT < 2015-10-01 or ( DSCHRGDT is NULL and CLM_THRU_DT < 2015-10-01 ) then ICD-9-CM Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and ( DSCHRGDT >= 2015-10-01 or ( DSCHRGDT is NULL and CLM_THRU_DT >= 2015-10-01 ) ) then ICD-10-CM Otherwise Unspecified |
CMS CJR Outpatient Claim Load
| AdmittingDiagnosisId |
NULL |
| AdmittingDiagnosisIdType |
NotApplicable |
CMS CJR Part B Claim Load
| AdmittingDiagnosisId |
NULL |
| AdmittingDiagnosisIdType |
NotApplicable |
CMS CJR Skilled Nursing Facility Claim Load
| AdmittingDiagnosisId |
|
||||||
| AdmittingDiagnosisIdType |
|
||||||
|
If DGNS_PRCDR_ICD_IND = 9-ICD-9 or DSCHRGDT < 2015-10-01 or ( DSCHRGDT is NULL and CLM_THRU_DT < 2015-10-01 ) then ICD-9-CM Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and ( DSCHRGDT >= 2015-10-01 or ( DSCHRGDT is NULL and CLM_THRU_DT >= 2015-10-01 ) ) then ICD-10-CM Otherwise Unspecified |
Data Aggregation Medical Claim Load
| AdmittingDiagnosisId |
|
||
| AdmittingDiagnosisIdType |
|
||
|
"EpicDiagnosisId" |
Data Aggregation Pharmacy Claim Load
| AdmittingDiagnosisId | |
| AdmittingDiagnosisIdType |
"NotApplicable" |
Externally Adjudicated Medical Claim Load
| AdmittingDiagnosisId |
|
||
| AdmittingDiagnosisIdType |
"EpicDiagnosisId" |
Externally Adjudicated Pharmacy Claim Load
| AdmittingDiagnosisId | |
| AdmittingDiagnosisIdType |
"NotApplicable" |
Payer System Medical Claim Load
| AdmittingDiagnosisId |
|
||
| AdmittingDiagnosisIdType |
|
||
|
"EpicDiagnosisId" |
Payer System Pharmacy Claim Load
| AdmittingDiagnosisId | |
| AdmittingDiagnosisIdType |
"NotApplicable" |
Received Claim Load
| AdmittingDiagnosisId |
|
||
| AdmittingDiagnosisIdType |
"EpicDiagnosisId" |
Received Pharmacy Claim Load
| AdmittingDiagnosisId | |
| AdmittingDiagnosisIdType |
"NotApplicable" |
DiagnosisComboKey
: integerAll diagnoses associated with the claim
Properties
- Data type
- integer
- SQL Server data type
- bigint
- Allows null
- No
- Default value
- -1
- Delete value
- -3
Data Lineage for Each Package
CMS ACO Part A Files Load
| DiagnosisComboId |
|
||
| DiagnosisComboIdType |
"MsspClaimUniqueId" |
CMS ACO Part B DME File Load
| DiagnosisComboId |
NULL |
| DiagnosisComboIdType |
"NotApplicable" |
CMS ACO Part B Physicians File Load
| DiagnosisComboId |
|
||
| DiagnosisComboIdType |
"MsspClaimUniqueId" |
CMS ACO Part D Prescription Drug File Load
| DiagnosisComboId |
NULL |
| DiagnosisComboIdType |
"NotApplicable" |
CMS CJR DME Claim Load
| DiagnosisComboId |
GEO_BENE_SK|CLM_DT_SGNTR_SK|CLM_TYPE_CD|CLM_NUM_SK |
| DiagnosisComboIdType |
CmsCjrUniqueClaimId |
CMS CJR Home Health Claim Load
| DiagnosisComboId |
GEO_BENE_SK|CLM_DT_SGNTR_SK|CLM_TYPE_CD|CLM_NUM_SK |
| DiagnosisComboIdType |
CmsCjrUniqueClaimId |
CMS CJR Hospice Claim Load
| DiagnosisComboId |
GEO_BENE_SK|CLM_DT_SGNTR_SK|CLM_TYPE_CD|CLM_NUM_SK |
| DiagnosisComboIdType |
CmsCjrUniqueClaimId |
CMS CJR Inpatient Claim Load
| DiagnosisComboId |
GEO_BENE_SK|CLM_DT_SGNTR_SK|CLM_TYPE_CD|CLM_NUM_SK |
| DiagnosisComboIdType |
CmsCjrUniqueClaimId |
CMS CJR Outpatient Claim Load
| DiagnosisComboId |
GEO_BENE_SK|CLM_DT_SGNTR_SK|CLM_TYPE_CD|CLM_NUM_SK |
| DiagnosisComboIdType |
CmsCjrUniqueClaimId |
CMS CJR Part B Claim Load
| DiagnosisComboId |
GEO_BENE_SK|CLM_DT_SGNTR_SK|CLM_TYPE_CD|CLM_NUM_SK |
| DiagnosisComboIdType |
CmsCjrUniqueClaimId |
CMS CJR Skilled Nursing Facility Claim Load
| DiagnosisComboId |
GEO_BENE_SK|CLM_DT_SGNTR_SK|CLM_TYPE_CD|CLM_NUM_SK |
| DiagnosisComboIdType |
CmsCjrUniqueClaimId |
Data Aggregation Medical Claim Load
| DiagnosisComboId |
|
||
| DiagnosisComboIdType |
"EpicClaimInformationId:ReceivedClaim" |
Data Aggregation Pharmacy Claim Load
| DiagnosisComboId |
|
||
| DiagnosisComboIdType |
Externally Adjudicated Medical Claim Load
| DiagnosisComboId |
|
||
| DiagnosisComboIdType |
"EpicClaimInformationId:ReceivedClaim" |
Externally Adjudicated Pharmacy Claim Load
| DiagnosisComboId | |
| DiagnosisComboIdType |
"NotApplicable" |
Payer System Medical Claim Load
| DiagnosisComboId |
|
||
| DiagnosisComboIdType |
"EpicClaimInformationId:ReceivedClaim" |
Payer System Pharmacy Claim Load
| DiagnosisComboId |
|
||
| DiagnosisComboIdType |
Received Claim Load
| DiagnosisComboId |
|
||
| DiagnosisComboIdType |
"EpicClaimInformationId:ReceivedClaim" |
Received Pharmacy Claim Load
| DiagnosisComboId | |
| DiagnosisComboIdType |
"NotApplicable" |
DiagnosisComboIdTypeId
: integerThe IdTypeId corresponding to the DiagnosisBridge lookup
Properties
- Data type
- integer
- SQL Server data type
- smallint
- Allows null
- Yes
DiagnosisNumericId
: numberThe NumericId corresponding to the DiagnosisBridge lookup. If this column is populated, then DiagnosisComboId will not be populated. Cannot and should not be populated by packages.
Properties
- Data type
- number
- SQL Server data type
- numeric(38,0)
- Allows null
- Yes
DiagnosisComboId
: stringThe Id corresponding to the DiagnosisBridge lookup
Properties
- Data type
- string
- SQL Server data type
- nvarchar(50)
- Allows null
- Yes
- Delete value
- empty string
Data Lineage for Each Package
CMS ACO Part A Files Load
| DiagnosisComboId |
|
||
CMS ACO Part B DME File Load
| DiagnosisComboId |
NULL |
CMS ACO Part B Physicians File Load
| DiagnosisComboId |
|
||
CMS ACO Part D Prescription Drug File Load
| DiagnosisComboId |
NULL |
CMS CJR DME Claim Load
| DiagnosisComboId |
GEO_BENE_SK|CLM_DT_SGNTR_SK|CLM_TYPE_CD|CLM_NUM_SK |
CMS CJR Home Health Claim Load
| DiagnosisComboId |
GEO_BENE_SK|CLM_DT_SGNTR_SK|CLM_TYPE_CD|CLM_NUM_SK |
CMS CJR Hospice Claim Load
| DiagnosisComboId |
GEO_BENE_SK|CLM_DT_SGNTR_SK|CLM_TYPE_CD|CLM_NUM_SK |
CMS CJR Inpatient Claim Load
| DiagnosisComboId |
GEO_BENE_SK|CLM_DT_SGNTR_SK|CLM_TYPE_CD|CLM_NUM_SK |
CMS CJR Outpatient Claim Load
| DiagnosisComboId |
GEO_BENE_SK|CLM_DT_SGNTR_SK|CLM_TYPE_CD|CLM_NUM_SK |
CMS CJR Part B Claim Load
| DiagnosisComboId |
GEO_BENE_SK|CLM_DT_SGNTR_SK|CLM_TYPE_CD|CLM_NUM_SK |
CMS CJR Skilled Nursing Facility Claim Load
| DiagnosisComboId |
GEO_BENE_SK|CLM_DT_SGNTR_SK|CLM_TYPE_CD|CLM_NUM_SK |
Data Aggregation Medical Claim Load
| DiagnosisComboId |
|
||
Data Aggregation Pharmacy Claim Load
| DiagnosisComboId |
|
||
Externally Adjudicated Medical Claim Load
| DiagnosisComboId |
|
||
Payer System Medical Claim Load
| DiagnosisComboId |
|
||
Payer System Pharmacy Claim Load
| DiagnosisComboId |
|
||
Received Claim Load
| DiagnosisComboId |
|
||
FirstDiagnosisKey
: integerFirst diagnosis associated with the claim
Properties
- Data type
- integer
- SQL Server data type
- bigint
- Allows null
- No
- Default value
- -1
- Delete value
- -3
Data Lineage for Each Package
CMS ACO Part A Files Load
| FirstDiagnosisId |
|
||||
|
CLM_DGNS_CD where CLM_VAL_SQNC_NUM = 1 |
|||||
| FirstDiagnosisIdType |
|
||||
|
If DGNS_PRCDR_ICD_IND = 9-ICD 9 or FileGenerationDate < 2015-11-1 then "ICD-9-CM" Otherwise if DGNS_PRCDR_ICD_IND = 0-ICD 10 and FileGenerationDate >= 2015-11-1 then "ICD-10-CM" Otherwise "Unspecified" |
CMS ACO Part B DME File Load
| FirstDiagnosisId |
NULL |
| FirstDiagnosisIdType |
"NotApplicable" |
CMS ACO Part B Physicians File Load
| FirstDiagnosisId |
|
||||||||||||||||||||||||||||
|
Unpivot CLM_DGNS_1_CD, CLM_DGNS_2_CD, CLM_DGNS_3_CD, CLM_DGNS_4_CD, CLM_DGNS_5_CD, CLM_DGNS_6_CD, CLM_DGNS_7_CD, CLM_DGNS_8_CD, CLM_DGNS_9_CD, CLM_DGNS_10_CD, CLM_DGNS_11_CD, CLM_DGNS_12_CD where row is numbered 1 by ( where DGNS_PRCDR_ICD_IND = 9-ICD 9 or DGNS_PRCDR_ICD_IND = 0-ICD 10 then 1 otherwise 2 ) then by minimum pivoted column name for each CUR_CLM_UNIQ_ID and CUR_CLM_UNIQ_ID is not NULL and unpivoted column is not NULL |
|||||||||||||||||||||||||||||
| FirstDiagnosisIdType |
|
||||||||||||||||||||||||||||
|
If DGNS_PRCDR_ICD_IND = 9-ICD 9 or FileGenerationDate <2015-11-1 then "ICD-9-CM" Otherwise if DGNS_PRCDR_ICD_IND = 0-ICD 10 and FileGenerationDate >= 2015-11-1 then "ICD-10-CM" Otherwise "Unspecified" |
CMS ACO Part D Prescription Drug File Load
| FirstDiagnosisId |
NULL |
| FirstDiagnosisIdType |
"NotApplicable" |
CMS CJR DME Claim Load
| FirstDiagnosisId |
If CODE_VALUE is not NULL then CODE_VALUE |
||||
| FirstDiagnosisIdType |
|
||||
|
If CODE_VALUE is NULL then Unspecified Otherwise if DGNS_PRCDR_ICD_IND = 9-ICD-9 or CLM_THRU_DT < 2015-10-01 then ICD-9-CM Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and CLM_THRU_DT >= 2015-10-01 then ICD-10-CM Otherwise NULL |
CMS CJR Home Health Claim Load
| FirstDiagnosisId |
If CODE_VALUE is not NULL then CODE_VALUE |
||||
| FirstDiagnosisIdType |
|
||||
|
If CODE_VALUE is NULL then Unspecified Otherwise if DGNS_PRCDR_ICD_IND = 9-ICD-9 or CLM_THRU_DT < 2015-10-01 then ICD-9-CM Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and CLM_THRU_DT >= 2015-10-01 then ICD-10-CM Otherwise NULL |
CMS CJR Hospice Claim Load
| FirstDiagnosisId |
If CODE_VALUE is not NULL then CODE_VALUE |
||||
| FirstDiagnosisIdType |
|
||||
|
If CODE_VALUE is NULL then Unspecified Otherwise if DGNS_PRCDR_ICD_IND = 9-ICD-9 or CLM_THRU_DT < 2015-10-01 then ICD-9-CM Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and CLM_THRU_DT >= 2015-10-01 then ICD-10-CM Otherwise NULL |
CMS CJR Inpatient Claim Load
| FirstDiagnosisId |
If CODE_VALUE is not NULL then CODE_VALUE |
||||||
| FirstDiagnosisIdType |
|
||||||
|
If CODE_VALUE is NULL then Unspecified Otherwise if DGNS_PRCDR_ICD_IND = 9-ICD-9 or DSCHRGDT < 2015-10-01 or ( DSCHRGDT is NULL and CLM_THRU_DT < 2015-10-01 ) then ICD-9-CM Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and ( DSCHRGDT >= 2015-10-01 or ( DSCHRGDT is NULL and CLM_THRU_DT >= 2015-10-01 ) ) then ICD-10-CM Otherwise NULL |
CMS CJR Outpatient Claim Load
| FirstDiagnosisId |
If CODE_VALUE is not NULL then CODE_VALUE |
||||
| FirstDiagnosisIdType |
|
||||
|
If CODE_VALUE is NULL then Unspecified Otherwise if DGNS_PRCDR_ICD_IND = 9-ICD-9 or CLM_THRU_DT < 2015-10-01 then ICD-9-CM Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and CLM_THRU_DT >= 2015-10-01 then ICD-10-CM Otherwise NULL |
CMS CJR Part B Claim Load
| FirstDiagnosisId |
If CODE_VALUE is not NULL then CODE_VALUE |
||||
| FirstDiagnosisIdType |
|
||||
|
If CODE_VALUE is NULL then Unspecified Otherwise if DGNS_PRCDR_ICD_IND = 9-ICD-9 or CLM_THRU_DT < 2015-10-01 then ICD-9-CM Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and CLM_THRU_DT >= 2015-10-01 then ICD-10-CM Otherwise NULL |
CMS CJR Skilled Nursing Facility Claim Load
| FirstDiagnosisId |
|
||||||
| FirstDiagnosisIdType |
|
||||||
|
If CODE_VALUE is NULL then Unspecified Otherwise if DGNS_PRCDR_ICD_IND = 9-ICD-9 or DSCHRGDT < 2015-10-01 or ( DSCHRGDT is NULL and CLM_THRU_DT < 2015-10-01 ) then ICD-9-CM Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and ( DSCHRGDT >= 2015-10-01 or ( DSCHRGDT is NULL and CLM_THRU_DT >= 2015-10-01 ) ) then ICD-10-CM Otherwise NULL |
Data Aggregation Medical Claim Load
| FirstDiagnosisId |
|
||||
| FirstDiagnosisIdType |
|
||||
|
If FIRSTDXID is not NULL then "EpicDiagnosisId" Otherwise "NotApplicable" |
Data Aggregation Pharmacy Claim Load
| FirstDiagnosisId |
|
||||
| FirstDiagnosisIdType |
"EpicDiagnosisId" |
Externally Adjudicated Medical Claim Load
| FirstDiagnosisId |
|
||||
|
DX_ID where LINE = 1 |
|||||
| FirstDiagnosisIdType |
"EpicDiagnosisId" |
Externally Adjudicated Pharmacy Claim Load
| FirstDiagnosisId | |
| FirstDiagnosisIdType |
"NotApplicable" |
Payer System Medical Claim Load
| FirstDiagnosisId |
|
||||
| FirstDiagnosisIdType |
|
||||
|
If FIRSTDXID is not NULL then "EpicDiagnosisId" Otherwise "NotApplicable" |
Payer System Pharmacy Claim Load
| FirstDiagnosisId |
|
||||
| FirstDiagnosisIdType |
"EpicDiagnosisId" |
Received Claim Load
| FirstDiagnosisId |
|
||||
|
DX_ID where LINE = 1 |
|||||
| FirstDiagnosisIdType |
"EpicDiagnosisId" |
Received Pharmacy Claim Load
| FirstDiagnosisId | |
| FirstDiagnosisIdType |
"NotApplicable" |
PresentOnAdmissionDiagnosisComboKey
: integerAll diagnoses associated with the claim that were present on admission
Properties
- Data type
- integer
- SQL Server data type
- bigint
- Allows null
- No
- Default value
- -1
- Delete value
- -3
Data Lineage for Each Package
CMS ACO Part A Files Load
| PresentOnAdmissionDiagnosisComboId |
|
||
| PresentOnAdmissionDiagnosisComboIdType |
"CmsAcoPresentOnAdmissionClaimUniqueId" |
CMS ACO Part B DME File Load
| PresentOnAdmissionDiagnosisComboId |
NULL |
| PresentOnAdmissionDiagnosisComboIdType |
"NotApplicable" |
CMS ACO Part B Physicians File Load
| PresentOnAdmissionDiagnosisComboId |
NULL |
| PresentOnAdmissionDiagnosisComboIdType |
"NotApplicable" |
CMS ACO Part D Prescription Drug File Load
| PresentOnAdmissionDiagnosisComboId |
NULL |
| PresentOnAdmissionDiagnosisComboIdType |
"NotApplicable" |
CMS CJR DME Claim Load
| PresentOnAdmissionDiagnosisComboId |
GEO_BENE_SK|CLM_DT_SGNTR_SK|CLM_TYPE_CD|CLM_NUM_SK |
| PresentOnAdmissionDiagnosisComboIdType |
CmsCjrUniqueClaimId:POA |
CMS CJR Home Health Claim Load
| PresentOnAdmissionDiagnosisComboId |
GEO_BENE_SK|CLM_DT_SGNTR_SK|CLM_TYPE_CD|CLM_NUM_SK |
| PresentOnAdmissionDiagnosisComboIdType |
CmsCjrUniqueClaimId:POA |
CMS CJR Hospice Claim Load
| PresentOnAdmissionDiagnosisComboId |
GEO_BENE_SK|CLM_DT_SGNTR_SK|CLM_TYPE_CD|CLM_NUM_SK |
| PresentOnAdmissionDiagnosisComboIdType |
CmsCjrUniqueClaimId:POA |
CMS CJR Inpatient Claim Load
| PresentOnAdmissionDiagnosisComboId |
GEO_BENE_SK|CLM_DT_SGNTR_SK|CLM_TYPE_CD|CLM_NUM_SK |
| PresentOnAdmissionDiagnosisComboIdType |
CmsCjrUniqueClaimId:POA |
CMS CJR Outpatient Claim Load
| PresentOnAdmissionDiagnosisComboId |
GEO_BENE_SK|CLM_DT_SGNTR_SK|CLM_TYPE_CD|CLM_NUM_SK |
| PresentOnAdmissionDiagnosisComboIdType |
CmsCjrUniqueClaimId:POA |
CMS CJR Part B Claim Load
| PresentOnAdmissionDiagnosisComboId |
GEO_BENE_SK|CLM_DT_SGNTR_SK|CLM_TYPE_CD|CLM_NUM_SK |
| PresentOnAdmissionDiagnosisComboIdType |
CmsCjrUniqueClaimId:POA |
CMS CJR Skilled Nursing Facility Claim Load
| PresentOnAdmissionDiagnosisComboId |
GEO_BENE_SK|CLM_DT_SGNTR_SK|CLM_TYPE_CD|CLM_NUM_SK |
| PresentOnAdmissionDiagnosisComboIdType |
CmsCjrUniqueClaimId:POA |
Data Aggregation Medical Claim Load
| PresentOnAdmissionDiagnosisComboId |
|
||
| PresentOnAdmissionDiagnosisComboIdType |
"EpicClaimInformationId:PresentOnAdmission" |
Data Aggregation Pharmacy Claim Load
| PresentOnAdmissionDiagnosisComboId | |
| PresentOnAdmissionDiagnosisComboIdType |
"NotApplicable" |
Externally Adjudicated Medical Claim Load
| PresentOnAdmissionDiagnosisComboId |
|
||
| PresentOnAdmissionDiagnosisComboIdType |
"EpicClaimInformationId:PresentOnAdmission" |
Externally Adjudicated Pharmacy Claim Load
| PresentOnAdmissionDiagnosisComboId | |
| PresentOnAdmissionDiagnosisComboIdType |
"NotApplicable" |
Payer System Medical Claim Load
| PresentOnAdmissionDiagnosisComboId |
|
||
| PresentOnAdmissionDiagnosisComboIdType |
"EpicClaimInformationId:PresentOnAdmission" |
Payer System Pharmacy Claim Load
| PresentOnAdmissionDiagnosisComboId | |
| PresentOnAdmissionDiagnosisComboIdType |
"NotApplicable" |
Received Claim Load
| PresentOnAdmissionDiagnosisComboId |
|
||
| PresentOnAdmissionDiagnosisComboIdType |
"EpicClaimInformationId:PresentOnAdmission" |
Received Pharmacy Claim Load
| PresentOnAdmissionDiagnosisComboId | |
| PresentOnAdmissionDiagnosisComboIdType |
"NotApplicable" |
PresentOnAdmissionDiagnosisComboIdTypeId
: integerThe IdTypeId corresponding to the DiagnosisBridge lookup
Properties
- Data type
- integer
- SQL Server data type
- smallint
- Allows null
- Yes
PresentOnAdmissionDiagnosisNumericId
: numberThe NumericId corresponding to the DiagnosisBridge lookup. If this column is populated, then PresentOnAdmissionDiagnosisComboId will not be populated. Cannot and should not be populated by packages.
Properties
- Data type
- number
- SQL Server data type
- numeric(38,0)
- Allows null
- Yes
PresentOnAdmissionDiagnosisComboId
: stringThe Id corresponding to the DiagnosisBridge lookup
Properties
- Data type
- string
- SQL Server data type
- nvarchar(50)
- Allows null
- Yes
- Delete value
- empty string
Data Lineage for Each Package
CMS ACO Part A Files Load
| PresentOnAdmissionDiagnosisComboId |
|
||
CMS ACO Part B DME File Load
| PresentOnAdmissionDiagnosisComboId |
NULL |
CMS ACO Part B Physicians File Load
| PresentOnAdmissionDiagnosisComboId |
NULL |
CMS ACO Part D Prescription Drug File Load
| PresentOnAdmissionDiagnosisComboId |
NULL |
CMS CJR DME Claim Load
| PresentOnAdmissionDiagnosisComboId |
GEO_BENE_SK|CLM_DT_SGNTR_SK|CLM_TYPE_CD|CLM_NUM_SK |
CMS CJR Home Health Claim Load
| PresentOnAdmissionDiagnosisComboId |
GEO_BENE_SK|CLM_DT_SGNTR_SK|CLM_TYPE_CD|CLM_NUM_SK |
CMS CJR Hospice Claim Load
| PresentOnAdmissionDiagnosisComboId |
GEO_BENE_SK|CLM_DT_SGNTR_SK|CLM_TYPE_CD|CLM_NUM_SK |
CMS CJR Inpatient Claim Load
| PresentOnAdmissionDiagnosisComboId |
GEO_BENE_SK|CLM_DT_SGNTR_SK|CLM_TYPE_CD|CLM_NUM_SK |
CMS CJR Outpatient Claim Load
| PresentOnAdmissionDiagnosisComboId |
GEO_BENE_SK|CLM_DT_SGNTR_SK|CLM_TYPE_CD|CLM_NUM_SK |
CMS CJR Part B Claim Load
| PresentOnAdmissionDiagnosisComboId |
GEO_BENE_SK|CLM_DT_SGNTR_SK|CLM_TYPE_CD|CLM_NUM_SK |
CMS CJR Skilled Nursing Facility Claim Load
| PresentOnAdmissionDiagnosisComboId |
GEO_BENE_SK|CLM_DT_SGNTR_SK|CLM_TYPE_CD|CLM_NUM_SK |
Data Aggregation Medical Claim Load
| PresentOnAdmissionDiagnosisComboId |
|
||
Externally Adjudicated Medical Claim Load
| PresentOnAdmissionDiagnosisComboId |
|
||
Payer System Medical Claim Load
| PresentOnAdmissionDiagnosisComboId |
|
||
Received Claim Load
| PresentOnAdmissionDiagnosisComboId |
|
||
SurgicalProcedureComboKey
: integerAll surgical procedures associated with the claim
ProcedureTerminologyDim will be deprecated in a future release. This key will be replaced with a key which joins to ProcedureMappingDim.
Properties
- Data type
- integer
- SQL Server data type
- bigint
- Allows null
- No
- Default value
- -1
- Delete value
- -3
Data Lineage for Each Package
CMS ACO Part A Files Load
| SurgicalProcedureComboId |
|
||
| SurgicalProcedureComboIdType |
"MsspClaimUniqueId" |
CMS ACO Part B DME File Load
| SurgicalProcedureComboId |
NULL |
| SurgicalProcedureComboIdType |
"NotApplicable" |
CMS ACO Part B Physicians File Load
| SurgicalProcedureComboId |
NULL |
| SurgicalProcedureComboIdType |
"NotApplicable" |
CMS ACO Part D Prescription Drug File Load
| SurgicalProcedureComboId |
NULL |
| SurgicalProcedureComboIdType |
"NotApplicable" |
CMS CJR DME Claim Load
| SurgicalProcedureComboId |
NULL |
| SurgicalProcedureComboIdType |
NotApplicable |
CMS CJR Home Health Claim Load
| SurgicalProcedureComboId |
NULL |
| SurgicalProcedureComboIdType |
NotApplicable |
CMS CJR Hospice Claim Load
| SurgicalProcedureComboId |
|
||||
|
GEO_BENE_SK|CLM_DT_SGNTR_SK|CLM_TYPE_CD|CLM_NUM_SK |
|||||
| SurgicalProcedureComboIdType |
CmsCjrUniqueClaimId |
CMS CJR Inpatient Claim Load
| SurgicalProcedureComboId |
|
||||||||
|
GEO_BENE_SK|CLM_DT_SGNTR_SK|CLM_TYPE_CD|CLM_NUM_SK |
|||||||||
| SurgicalProcedureComboIdType |
CmsCjrUniqueClaimId |
CMS CJR Outpatient Claim Load
| SurgicalProcedureComboId |
NULL |
| SurgicalProcedureComboIdType |
NotApplicable |
CMS CJR Part B Claim Load
| SurgicalProcedureComboId |
|
||||||||
|
GEO_BENE_SK|CLM_DT_SGNTR_SK|CLM_TYPE_CD|CLM_NUM_SK |
|||||||||
| SurgicalProcedureComboIdType |
CmsCjrUniqueClaimId |
CMS CJR Skilled Nursing Facility Claim Load
| SurgicalProcedureComboId |
|
||||||||
|
GEO_BENE_SK|CLM_DT_SGNTR_SK|CLM_TYPE_CD|CLM_NUM_SK |
|||||||||
| SurgicalProcedureComboIdType |
CmsCjrUniqueClaimId |
Data Aggregation Medical Claim Load
| SurgicalProcedureComboId |
|
||
| SurgicalProcedureComboIdType |
"EpicClaimInformationId" |
Data Aggregation Pharmacy Claim Load
| SurgicalProcedureComboId | |
| SurgicalProcedureComboIdType |
"NotApplicable" |
Externally Adjudicated Medical Claim Load
| SurgicalProcedureComboId |
|
||
| SurgicalProcedureComboIdType |
"EpicClaimInformationId" |
Externally Adjudicated Pharmacy Claim Load
| SurgicalProcedureComboId | |
| SurgicalProcedureComboIdType |
"NotApplicable" |
Payer System Medical Claim Load
| SurgicalProcedureComboId |
|
||
| SurgicalProcedureComboIdType |
"EpicClaimInformationId" |
Payer System Pharmacy Claim Load
| SurgicalProcedureComboId | |
| SurgicalProcedureComboIdType |
"NotApplicable" |
Received Claim Load
| SurgicalProcedureComboId |
|
||
| SurgicalProcedureComboIdType |
"EpicClaimInformationId" |
Received Pharmacy Claim Load
| SurgicalProcedureComboId | |
| SurgicalProcedureComboIdType |
"NotApplicable" |
SurgicalProcedureComboIdTypeId
: integer(No description)
Properties
- Data type
- integer
- SQL Server data type
- smallint
- Allows null
- Yes
SurgicalProcedureNumericId
: numberThe NumericId corresponding to the ProcedureTerminologyBridge lookup. If this column is populated, then ComboId will not be populated. Cannot and should not be populated by packages.
Properties
- Data type
- number
- SQL Server data type
- numeric(38,0)
- Allows null
- Yes
SurgicalProcedureComboId
: stringThe Id corresponding to the ProcedureTerminologyBridge lookup
Properties
- Data type
- string
- SQL Server data type
- nvarchar(50)
- Allows null
- Yes
- Delete value
- empty string
Data Lineage for Each Package
CMS ACO Part A Files Load
| SurgicalProcedureComboId |
|
||
CMS ACO Part B DME File Load
| SurgicalProcedureComboId |
NULL |
CMS ACO Part B Physicians File Load
| SurgicalProcedureComboId |
NULL |
CMS ACO Part D Prescription Drug File Load
| SurgicalProcedureComboId |
NULL |
CMS CJR DME Claim Load
| SurgicalProcedureComboId |
NULL |
CMS CJR Home Health Claim Load
| SurgicalProcedureComboId |
NULL |
CMS CJR Hospice Claim Load
| SurgicalProcedureComboId |
|
||||
|
GEO_BENE_SK|CLM_DT_SGNTR_SK|CLM_TYPE_CD|CLM_NUM_SK |
CMS CJR Inpatient Claim Load
| SurgicalProcedureComboId |
|
||||||||
|
GEO_BENE_SK|CLM_DT_SGNTR_SK|CLM_TYPE_CD|CLM_NUM_SK |
CMS CJR Outpatient Claim Load
| SurgicalProcedureComboId |
NULL |
CMS CJR Part B Claim Load
| SurgicalProcedureComboId |
|
||||||||
|
GEO_BENE_SK|CLM_DT_SGNTR_SK|CLM_TYPE_CD|CLM_NUM_SK |
CMS CJR Skilled Nursing Facility Claim Load
| SurgicalProcedureComboId |
|
||||||||
|
GEO_BENE_SK|CLM_DT_SGNTR_SK|CLM_TYPE_CD|CLM_NUM_SK |
Data Aggregation Medical Claim Load
| SurgicalProcedureComboId |
|
||
Externally Adjudicated Medical Claim Load
| SurgicalProcedureComboId |
|
||
Payer System Medical Claim Load
| SurgicalProcedureComboId |
|
||
Received Claim Load
| SurgicalProcedureComboId |
|
||
PrimaryProcedureKey
: integerPrimary procedure on the claim
Properties
- Data type
- integer
- SQL Server data type
- bigint
- Allows null
- No
- Default value
- -1
- Delete value
- -3
Data Lineage for Each Package
CMS ACO Part A Files Load
| PrimaryProcedureId |
NULL |
||
| PrimaryProcedureIdType |
"Unspecified" |
||
| StartDate |
|
||
|
If CLM_FROM_DT < 1/1/1753 or CLM_FROM_DT = 12/31/9999 then NULL Otherwise CLM_FROM_DT |
CMS ACO Part B DME File Load
| PrimaryProcedureId |
NULL |
||
| PrimaryProcedureIdType |
"NotApplicable" |
||
| StartDate |
|
||
|
If CLM_FROM_DT < 1/1/1753 or CLM_FROM_DT = 12/31/9999 then NULL Otherwise CLM_FROM_DT |
CMS ACO Part B Physicians File Load
| PrimaryProcedureId |
NULL |
||
| PrimaryProcedureIdType |
"NotApplicable" |
||
| StartDate |
|
||
|
If CLM_FROM_DT < 1/1/1753 or CLM_FROM_DT = 12/31/9999 then NULL Otherwise CLM_FROM_DT |
CMS ACO Part D Prescription Drug File Load
| PrimaryProcedureId |
NULL |
||
| PrimaryProcedureIdType |
"NotApplicable" |
||
| StartDate |
|
||
|
If CLM_LINE_FROM_DT < 1/1/1753 or CLM_LINE_FROM_DT = 12/31/9999 then NULL Otherwise CLM_LINE_FROM_DT |
CMS CJR DME Claim Load
| PrimaryProcedureId |
NULL |
||
| PrimaryProcedureIdType |
"NotApplicable" |
||
| StartDate |
|
||
CMS CJR Home Health Claim Load
| PrimaryProcedureId |
NULL |
||
| PrimaryProcedureIdType |
"NotApplicable" |
||
| StartDate |
|
||
CMS CJR Hospice Claim Load
| PrimaryProcedureId |
NULL |
||
| PrimaryProcedureIdType |
"Unspecified" |
||
| StartDate |
|
||
CMS CJR Inpatient Claim Load
| PrimaryProcedureId |
NULL |
||
| PrimaryProcedureIdType |
"Unspecified" |
||
| StartDate |
|
||
CMS CJR Outpatient Claim Load
| PrimaryProcedureId |
NULL |
||
| PrimaryProcedureIdType |
"NotApplicable" |
||
| StartDate |
|
||
CMS CJR Part B Claim Load
| PrimaryProcedureId |
NULL |
||
| PrimaryProcedureIdType |
"NotApplicable" |
||
| StartDate |
|
||
CMS CJR Skilled Nursing Facility Claim Load
| PrimaryProcedureId |
NULL |
||
| PrimaryProcedureIdType |
"NotApplicable" |
||
| StartDate |
|
||
Data Aggregation Medical Claim Load
| PrimaryProcedureId |
|
||||
| PrimaryProcedureIdType |
|
||||
|
If PRIMARYPROCEDUREID is not NULL then "EpicIcdCode" Otherwise "NotApplicable" |
|||||
| StartDate |
|
||||
|
Minimum of STMT_COV_FROM_DATE - Time Zone: Unspecified and SERVICE_START_DATE - Time Zone: Unspecified |
Data Aggregation Pharmacy Claim Load
| PrimaryProcedureId | |||
| PrimaryProcedureIdType |
"NotApplicable" |
||
| StartDate |
|
||
Externally Adjudicated Medical Claim Load
| PrimaryProcedureId |
NULL |
||||
| PrimaryProcedureIdType |
"Unspecified" |
||||
| StartDate |
|
||||
|
Minimum of STMT_COV_FROM_DATE - Time Zone: Unspecified and SERVICE_START_DATE - Time Zone: Unspecified |
Externally Adjudicated Pharmacy Claim Load
| PrimaryProcedureId | |||
| PrimaryProcedureIdType |
"NotApplicable" |
||
| StartDate |
|
||
Payer System Medical Claim Load
| PrimaryProcedureId |
NULL |
||||
| PrimaryProcedureIdType |
"Unspecified" |
||||
| StartDate |
|
||||
|
Minimum of STMT_COV_FROM_DATE - Time Zone: Unspecified and SERVICE_START_DATE - Time Zone: Unspecified |
Payer System Pharmacy Claim Load
| PrimaryProcedureId | |||
| PrimaryProcedureIdType |
"NotApplicable" |
||
| StartDate |
|
||
Received Claim Load
| PrimaryProcedureId |
NULL |
||||
| PrimaryProcedureIdType |
"Unspecified" |
||||
| StartDate |
|
||||
|
Minimum of STMT_COV_FROM_DATE - Time Zone: Unspecified and SERVICE_START_DATE - Time Zone: Unspecified |
Received Pharmacy Claim Load
| PrimaryProcedureId | |||
| PrimaryProcedureIdType |
"NotApplicable" |
||
| StartDate |
|
||
PrimaryProcedureDurableKey
: integerPrimary procedure on the claim
Properties
- Data type
- integer
- SQL Server data type
- bigint
- Allows null
- No
- Default value
- -1
- Delete value
- -3
Data Lineage for Each Package
CMS ACO Part A Files Load
| PrimaryProcedureId |
NULL |
| PrimaryProcedureIdType |
"Unspecified" |
CMS ACO Part B DME File Load
| PrimaryProcedureId |
NULL |
| PrimaryProcedureIdType |
"NotApplicable" |
CMS ACO Part B Physicians File Load
| PrimaryProcedureId |
NULL |
| PrimaryProcedureIdType |
"NotApplicable" |
CMS ACO Part D Prescription Drug File Load
| PrimaryProcedureId |
NULL |
| PrimaryProcedureIdType |
"NotApplicable" |
CMS CJR DME Claim Load
| PrimaryProcedureId |
NULL |
| PrimaryProcedureIdType |
"NotApplicable" |
CMS CJR Home Health Claim Load
| PrimaryProcedureId |
NULL |
| PrimaryProcedureIdType |
"NotApplicable" |
CMS CJR Hospice Claim Load
| PrimaryProcedureId |
NULL |
| PrimaryProcedureIdType |
"Unspecified" |
CMS CJR Inpatient Claim Load
| PrimaryProcedureId |
NULL |
| PrimaryProcedureIdType |
"Unspecified" |
CMS CJR Outpatient Claim Load
| PrimaryProcedureId |
NULL |
| PrimaryProcedureIdType |
"NotApplicable" |
CMS CJR Part B Claim Load
| PrimaryProcedureId |
NULL |
| PrimaryProcedureIdType |
"NotApplicable" |
CMS CJR Skilled Nursing Facility Claim Load
| PrimaryProcedureId |
NULL |
| PrimaryProcedureIdType |
"NotApplicable" |
Data Aggregation Medical Claim Load
| PrimaryProcedureId |
|
||||
| PrimaryProcedureIdType |
|
||||
|
If PRIMARYPROCEDUREID is not NULL then "EpicIcdCode" Otherwise "NotApplicable" |
Data Aggregation Pharmacy Claim Load
| PrimaryProcedureId | |
| PrimaryProcedureIdType |
"NotApplicable" |
Externally Adjudicated Medical Claim Load
| PrimaryProcedureId |
NULL |
| PrimaryProcedureIdType |
"Unspecified" |
Externally Adjudicated Pharmacy Claim Load
| PrimaryProcedureId | |
| PrimaryProcedureIdType |
"NotApplicable" |
Payer System Medical Claim Load
| PrimaryProcedureId |
NULL |
| PrimaryProcedureIdType |
"Unspecified" |
Payer System Pharmacy Claim Load
| PrimaryProcedureId | |
| PrimaryProcedureIdType |
"NotApplicable" |
Received Claim Load
| PrimaryProcedureId |
NULL |
| PrimaryProcedureIdType |
"Unspecified" |
Received Pharmacy Claim Load
| PrimaryProcedureId | |
| PrimaryProcedureIdType |
"NotApplicable" |
FirstProcedureKey
: integerFirst procedure associated with the claim
Properties
- Data type
- integer
- SQL Server data type
- bigint
- Allows null
- No
- Default value
- -1
- Delete value
- -3
Data Lineage for Each Package
CMS ACO Part A Files Load
| FirstProcedureId |
|
||||
|
CLM_PRCDR_CD where CLM_VAL_SQNC_NUM = 1 |
|||||
| FirstProcedureIdType |
|
||||
|
If DGNS_PRCDR_ICD_IND = 9-ICD 9 or FileGenerationDate < 2015-11-1 then "ICD-9-CM" Otherwise if DGNS_PRCDR_ICD_IND = 0-ICD 10 and FileGenerationDate >= 2015-11-1 then "ICD-10-PCS" Otherwise "Unspecified" |
|||||
| StartDate |
|
||||
|
If CLM_FROM_DT < 1/1/1753 or CLM_FROM_DT = 12/31/9999 then NULL Otherwise CLM_FROM_DT |
CMS ACO Part B DME File Load
| FirstProcedureId |
NULL |
||
| FirstProcedureIdType |
"NotApplicable" |
||
| StartDate |
|
||
|
If CLM_FROM_DT < 1/1/1753 or CLM_FROM_DT = 12/31/9999 then NULL Otherwise CLM_FROM_DT |
CMS ACO Part B Physicians File Load
| FirstProcedureId |
NULL |
||
| FirstProcedureIdType |
"NotApplicable" |
||
| StartDate |
|
||
|
If CLM_FROM_DT < 1/1/1753 or CLM_FROM_DT = 12/31/9999 then NULL Otherwise CLM_FROM_DT |
CMS ACO Part D Prescription Drug File Load
| FirstProcedureId |
NULL |
||
| FirstProcedureIdType |
"NotApplicable" |
||
| StartDate |
|
||
|
If CLM_LINE_FROM_DT < 1/1/1753 or CLM_LINE_FROM_DT = 12/31/9999 then NULL Otherwise CLM_LINE_FROM_DT |
CMS CJR DME Claim Load
| FirstProcedureId |
NULL |
||
| FirstProcedureIdType |
"NotApplicable" |
||
| StartDate |
|
||
CMS CJR Home Health Claim Load
| FirstProcedureId |
NULL |
||
| FirstProcedureIdType |
"NotApplicable" |
||
| StartDate |
|
||
CMS CJR Hospice Claim Load
| FirstProcedureId |
|
||||||
|
First CODE_VALUE for the claim where CLM_PROD_TYPE_CD = "S"-Procedure and CLM_VAL_SQNC_NUM = 1 |
|||||||
| FirstProcedureIdType |
If DGNS_PRCDR_ICD_IND = 9-ICD-9 or CLM_THRU_DT < 2015-10-01 then "ICD-9-CM" Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and CLM_THRU_DT >= 2015-10-01 then "ICD-10-PCS" Otherwise "Unspecified" |
||||||
| StartDate |
|
||||||
CMS CJR Inpatient Claim Load
| FirstProcedureId |
|
||||||
|
First CODE_VALUE for the claim where CLM_PROD_TYPE_CD = "S"-Procedure and CLM_VAL_SQNC_NUM = 1 |
|||||||
| FirstProcedureIdType |
|
||||||
|
If DGNS_PRCDR_ICD_IND = 9-ICD-9 or DSCHRGDT < 2015-10-01 or ( DSCHRGDT is NULL and CLM_THRU_DT < 2015-10-01 ) then "ICD-9-CM" Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and ( DSCHRGDT >= 2015-10-01 or ( DSCHRGDT is NULL and CLM_THRU_DT >= 2015-10-01 ) ) then "ICD-10-PCS" Otherwise "Unspecified" |
|||||||
| StartDate |
|
||||||
CMS CJR Outpatient Claim Load
| FirstProcedureId |
NULL |
||
| FirstProcedureIdType |
"NotApplicable" |
||
| StartDate |
|
||
CMS CJR Part B Claim Load
| FirstProcedureId |
NULL |
||
| FirstProcedureIdType |
"NotApplicable" |
||
| StartDate |
|
||
CMS CJR Skilled Nursing Facility Claim Load
| FirstProcedureId |
|
||||||
|
First CODE_VALUE for the claim where CLM_PROD_TYPE_CD = "S"-Procedure and CLM_VAL_SQNC_NUM = 1 |
|||||||
| FirstProcedureIdType |
|
||||||
|
If DGNS_PRCDR_ICD_IND = 9-ICD-9 or DSCHRGDT < 2015-10-01 or ( DSCHRGDT is NULL and CLM_THRU_DT < 2015-10-01 ) then "ICD-9-CM" Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and ( DSCHRGDT >= 2015-10-01 or ( DSCHRGDT is NULL and CLM_THRU_DT >= 2015-10-01 ) ) then "ICD-10-PCS" Otherwise "Unspecified" |
|||||||
| StartDate |
|
||||||
Data Aggregation Medical Claim Load
| FirstProcedureId | |||||
| FirstProcedureIdType | |||||
| StartDate |
|
||||
|
Minimum of STMT_COV_FROM_DATE - Time Zone: Unspecified and SERVICE_START_DATE - Time Zone: Unspecified |
Data Aggregation Pharmacy Claim Load
| FirstProcedureId | |||
| FirstProcedureIdType |
"NotApplicable" |
||
| StartDate |
|
||
Externally Adjudicated Medical Claim Load
| FirstProcedureId |
|
||||
|
ICD_PX_ID where LINE = 1 |
|||||
| FirstProcedureIdType |
"EpicIcdCode" |
||||
| StartDate |
|
||||
|
Minimum of STMT_COV_FROM_DATE - Time Zone: Unspecified and SERVICE_START_DATE - Time Zone: Unspecified |
Externally Adjudicated Pharmacy Claim Load
| FirstProcedureId | |||
| FirstProcedureIdType |
"NotApplicable" |
||
| StartDate |
|
||
Payer System Medical Claim Load
| FirstProcedureId | |||||
| FirstProcedureIdType | |||||
| StartDate |
|
||||
|
Minimum of STMT_COV_FROM_DATE - Time Zone: Unspecified and SERVICE_START_DATE - Time Zone: Unspecified |
Payer System Pharmacy Claim Load
| FirstProcedureId | |||
| FirstProcedureIdType |
"NotApplicable" |
||
| StartDate |
|
||
Received Claim Load
| FirstProcedureId |
|
||||
|
ICD_PX_ID where LINE = 1 |
|||||
| FirstProcedureIdType |
"EpicIcdCode" |
||||
| StartDate |
|
||||
|
Minimum of STMT_COV_FROM_DATE - Time Zone: Unspecified and SERVICE_START_DATE - Time Zone: Unspecified |
Received Pharmacy Claim Load
| FirstProcedureId | |||
| FirstProcedureIdType |
"NotApplicable" |
||
| StartDate |
|
||
FirstProcedureDurableKey
: integerFirst procedure associated with the claim
Properties
- Data type
- integer
- SQL Server data type
- bigint
- Allows null
- No
- Default value
- -1
- Delete value
- -3
Data Lineage for Each Package
CMS ACO Part A Files Load
| FirstProcedureId |
|
||||
|
CLM_PRCDR_CD where CLM_VAL_SQNC_NUM = 1 |
|||||
| FirstProcedureIdType |
|
||||
|
If DGNS_PRCDR_ICD_IND = 9-ICD 9 or FileGenerationDate < 2015-11-1 then "ICD-9-CM" Otherwise if DGNS_PRCDR_ICD_IND = 0-ICD 10 and FileGenerationDate >= 2015-11-1 then "ICD-10-PCS" Otherwise "Unspecified" |
CMS ACO Part B DME File Load
| FirstProcedureId |
NULL |
| FirstProcedureIdType |
"NotApplicable" |
CMS ACO Part B Physicians File Load
| FirstProcedureId |
NULL |
| FirstProcedureIdType |
"NotApplicable" |
CMS ACO Part D Prescription Drug File Load
| FirstProcedureId |
NULL |
| FirstProcedureIdType |
"NotApplicable" |
CMS CJR DME Claim Load
| FirstProcedureId |
NULL |
| FirstProcedureIdType |
"NotApplicable" |
CMS CJR Home Health Claim Load
| FirstProcedureId |
NULL |
| FirstProcedureIdType |
"NotApplicable" |
CMS CJR Hospice Claim Load
| FirstProcedureId |
|
||||||
|
First CODE_VALUE for the claim where CLM_PROD_TYPE_CD = "S"-Procedure and CLM_VAL_SQNC_NUM = 1 |
|||||||
| FirstProcedureIdType |
If DGNS_PRCDR_ICD_IND = 9-ICD-9 or CLM_THRU_DT < 2015-10-01 then "ICD-9-CM" Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and CLM_THRU_DT >= 2015-10-01 then "ICD-10-PCS" Otherwise "Unspecified" |
CMS CJR Inpatient Claim Load
| FirstProcedureId |
|
||||||
|
First CODE_VALUE for the claim where CLM_PROD_TYPE_CD = "S"-Procedure and CLM_VAL_SQNC_NUM = 1 |
|||||||
| FirstProcedureIdType |
|
||||||
|
If DGNS_PRCDR_ICD_IND = 9-ICD-9 or DSCHRGDT < 2015-10-01 or ( DSCHRGDT is NULL and CLM_THRU_DT < 2015-10-01 ) then "ICD-9-CM" Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and ( DSCHRGDT >= 2015-10-01 or ( DSCHRGDT is NULL and CLM_THRU_DT >= 2015-10-01 ) ) then "ICD-10-PCS" Otherwise "Unspecified" |
CMS CJR Outpatient Claim Load
| FirstProcedureId |
NULL |
| FirstProcedureIdType |
"NotApplicable" |
CMS CJR Part B Claim Load
| FirstProcedureId |
NULL |
| FirstProcedureIdType |
"NotApplicable" |
CMS CJR Skilled Nursing Facility Claim Load
| FirstProcedureId |
|
||||||
|
First CODE_VALUE for the claim where CLM_PROD_TYPE_CD = "S"-Procedure and CLM_VAL_SQNC_NUM = 1 |
|||||||
| FirstProcedureIdType |
|
||||||
|
If DGNS_PRCDR_ICD_IND = 9-ICD-9 or DSCHRGDT < 2015-10-01 or ( DSCHRGDT is NULL and CLM_THRU_DT < 2015-10-01 ) then "ICD-9-CM" Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and ( DSCHRGDT >= 2015-10-01 or ( DSCHRGDT is NULL and CLM_THRU_DT >= 2015-10-01 ) ) then "ICD-10-PCS" Otherwise "Unspecified" |
Data Aggregation Pharmacy Claim Load
| FirstProcedureId | |
| FirstProcedureIdType |
"NotApplicable" |
Externally Adjudicated Medical Claim Load
| FirstProcedureId |
|
||||
|
ICD_PX_ID where LINE = 1 |
|||||
| FirstProcedureIdType |
"EpicIcdCode" |
Externally Adjudicated Pharmacy Claim Load
| FirstProcedureId | |
| FirstProcedureIdType |
"NotApplicable" |
Payer System Pharmacy Claim Load
| FirstProcedureId | |
| FirstProcedureIdType |
"NotApplicable" |
Received Claim Load
| FirstProcedureId |
|
||||
|
ICD_PX_ID where LINE = 1 |
|||||
| FirstProcedureIdType |
"EpicIcdCode" |
Received Pharmacy Claim Load
| FirstProcedureId | |
| FirstProcedureIdType |
"NotApplicable" |
ContractKey
: integerContract associated with the claim
Properties
- Data type
- integer
- SQL Server data type
- bigint
- Allows null
- No
- Default value
- -1
- Delete value
- -3
Data Lineage for Each Package
CMS ACO Part A Files Load
| ContractId |
NULL |
| ContractIdType |
"NotApplicable" |
CMS ACO Part B DME File Load
| ContractId |
NULL |
| ContractIdType |
"NotApplicable" |
CMS ACO Part B Physicians File Load
| ContractId |
NULL |
| ContractIdType |
"NotApplicable" |
CMS ACO Part D Prescription Drug File Load
| ContractId |
NULL |
| ContractIdType |
"NotApplicable" |
CMS CJR DME Claim Load
| ContractId |
1 |
| ContractIdType |
CmsCjrContractId |
CMS CJR Home Health Claim Load
| ContractId |
1 |
| ContractIdType |
CmsCjrContractId |
CMS CJR Hospice Claim Load
| ContractId |
1 |
| ContractIdType |
CmsCjrContractId |
CMS CJR Inpatient Claim Load
| ContractId |
1 |
| ContractIdType |
CmsCjrContractId |
CMS CJR Outpatient Claim Load
| ContractId |
1 |
| ContractIdType |
CmsCjrContractId |
CMS CJR Part B Claim Load
| ContractId |
1 |
| ContractIdType |
CmsCjrContractId |
CMS CJR Skilled Nursing Facility Claim Load
| ContractId |
1 |
| ContractIdType |
CmsCjrContractId |
Externally Adjudicated Medical Claim Load
| ContractId |
|
||||||||||||||||||
|
This column is populated based on the contracts configured in ContractDim Component Configuration. Claims that are associated directly to value-based program records in Chronicles make use of the bridge to associate claims to contracts. Remaining claims will match to the most specific possible contract, based on the contract's configured Managed Care criteria. When evaluating contracts for matching, precedence is given to contracts for which Managed Care Employer Group Epic ID is specified, followed by contracts for which Managed Care Division Epic ID is specified, followed by contracts for which Managed Care Corporation Epic ID is specified, followed by contracts for which Managed Care Benefit Plan Epic ID is specified, followed by contracts for which Managed Care Line of Business Epic ID is specified, followed by contracts for which Managed Care Payor Epic ID is specified, followed by contracts for which Managed Care Business Segment Epic ID is specified. In order to match to a contract, the claim must match to a value in all specified Managed Care criteria for that contract. If multiple values are specified for a particular Managed Care criterion, the claim need only match to one of the specified values in order to be considered a match to that criterion. Only contracts which are Enabled in Component Configuration will be evaluated for matching. |
|||||||||||||||||||
| ContractIdType |
"ContractId" |
Externally Adjudicated Pharmacy Claim Load
| ContractId |
|
||
|
This column is populated based on the contracts configured in ContractDim Component Configuration. Claims that are associated directly to value-based program records in Chronicles make use of the bridge to associate claims to contracts. Remaining claims will match to the most specific possible contract, based on the contract's configured Managed Care criteria. When evaluating contracts for matching, precedence is given to contracts for which Managed Care Business Segment Epic ID is specified. In order to match to a contract, the claim must match to a value in all specified Managed Care criteria for that contract. If multiple values are specified for a particular Managed Care criterion, the claim need only match to one of the specified values in order to be considered a match to that criterion. Only contracts which are Enabled in Component Configuration will be evaluated for matching. |
|||
| ContractIdType |
"ContractId" |
Received Claim Load
| ContractId |
|
||
|
This column is populated based on the contracts configured in ContractDim Component Configuration. Claims that are associated directly to value-based program records in Chronicles make use of the bridge to associate claims to contracts. Remaining claims will match to the most specific possible contract, based on the contract's configured Managed Care criteria. When evaluating contracts for matching, precedence is given to contracts for which Managed Care Employer Group Epic ID is specified, followed by contracts for which Managed Care Division Epic ID is specified, followed by contracts for which Managed Care Corporation Epic ID is specified, followed by contracts for which Managed Care Benefit Plan Epic ID is specified, followed by contracts for which Managed Care Line of Business Epic ID is specified, followed by contracts for which Managed Care Payor Epic ID is specified, followed by contracts for which Managed Care Business Segment Epic ID is specified. In order to match to a contract, the claim must match to a value in all specified Managed Care criteria for that contract. If multiple values are specified for a particular Managed Care criterion, the claim need only match to one of the specified values in order to be considered a match to that criterion. Only contracts which are Enabled in Component Configuration will be evaluated for matching. |
|||
| ContractIdType |
"ContractId" |
Received Pharmacy Claim Load
| ContractId |
|
||
|
This column is populated based on the contracts configured in ContractDim Component Configuration. Claims that are associated directly to value-based program records in Chronicles make use of the bridge to associate claims to contracts. Remaining claims will match to the most specific possible contract, based on the contract's configured Managed Care criteria. When evaluating contracts for matching, precedence is given to contracts for which Managed Care Business Segment Epic ID is specified. In order to match to a contract, the claim must match to a value in all specified Managed Care criteria for that contract. If multiple values are specified for a particular Managed Care criterion, the claim need only match to one of the specified values in order to be considered a match to that criterion. Only contracts which are Enabled in Component Configuration will be evaluated for matching. |
|||
| ContractIdType |
"ContractId" |
ContractSourceDataKey
: integerContract associated with the claim
Properties
- Data type
- integer
- SQL Server data type
- bigint
- Allows null
- No
- Default value
- -1
- Delete value
- -3
Data Lineage for Each Package
CMS ACO Part A Files Load
| ContractId |
NULL |
| ContractIdType |
"NotApplicable" |
| ContractSourceName |
NULL (use source of the package) |
CMS ACO Part B DME File Load
| ContractId |
NULL |
| ContractIdType |
"NotApplicable" |
| ContractSourceName |
NULL (use source of the package) |
CMS ACO Part B Physicians File Load
| ContractId |
NULL |
| ContractIdType |
"NotApplicable" |
| ContractSourceName |
NULL (use source of the package) |
CMS ACO Part D Prescription Drug File Load
| ContractId |
NULL |
| ContractIdType |
"NotApplicable" |
| ContractSourceName |
NULL (use source of the package) |
CMS CJR DME Claim Load
| ContractId |
1 |
| ContractIdType |
CmsCjrContractId |
| ContractSourceName |
NULL (use source of the package) |
CMS CJR Home Health Claim Load
| ContractId |
1 |
| ContractIdType |
CmsCjrContractId |
| ContractSourceName |
NULL (use source of the package) |
CMS CJR Hospice Claim Load
| ContractId |
1 |
| ContractIdType |
CmsCjrContractId |
| ContractSourceName |
NULL (use source of the package) |
CMS CJR Inpatient Claim Load
| ContractId |
1 |
| ContractIdType |
CmsCjrContractId |
| ContractSourceName |
NULL (use source of the package) |
CMS CJR Outpatient Claim Load
| ContractId |
1 |
| ContractIdType |
CmsCjrContractId |
| ContractSourceName |
NULL (use source of the package) |
CMS CJR Part B Claim Load
| ContractId |
1 |
| ContractIdType |
CmsCjrContractId |
| ContractSourceName |
NULL (use source of the package) |
CMS CJR Skilled Nursing Facility Claim Load
| ContractId |
1 |
| ContractIdType |
CmsCjrContractId |
| ContractSourceName |
NULL (use source of the package) |
Externally Adjudicated Medical Claim Load
| ContractId |
|
||||||||||||||||||
|
This column is populated based on the contracts configured in ContractDim Component Configuration. Claims that are associated directly to value-based program records in Chronicles make use of the bridge to associate claims to contracts. Remaining claims will match to the most specific possible contract, based on the contract's configured Managed Care criteria. When evaluating contracts for matching, precedence is given to contracts for which Managed Care Employer Group Epic ID is specified, followed by contracts for which Managed Care Division Epic ID is specified, followed by contracts for which Managed Care Corporation Epic ID is specified, followed by contracts for which Managed Care Benefit Plan Epic ID is specified, followed by contracts for which Managed Care Line of Business Epic ID is specified, followed by contracts for which Managed Care Payor Epic ID is specified, followed by contracts for which Managed Care Business Segment Epic ID is specified. In order to match to a contract, the claim must match to a value in all specified Managed Care criteria for that contract. If multiple values are specified for a particular Managed Care criterion, the claim need only match to one of the specified values in order to be considered a match to that criterion. Only contracts which are Enabled in Component Configuration will be evaluated for matching. |
|||||||||||||||||||
| ContractIdType |
"ContractId" |
||||||||||||||||||
| ContractSourceName |
NULL (use source of the package) |
Externally Adjudicated Pharmacy Claim Load
| ContractId |
|
||
|
This column is populated based on the contracts configured in ContractDim Component Configuration. Claims that are associated directly to value-based program records in Chronicles make use of the bridge to associate claims to contracts. Remaining claims will match to the most specific possible contract, based on the contract's configured Managed Care criteria. When evaluating contracts for matching, precedence is given to contracts for which Managed Care Business Segment Epic ID is specified. In order to match to a contract, the claim must match to a value in all specified Managed Care criteria for that contract. If multiple values are specified for a particular Managed Care criterion, the claim need only match to one of the specified values in order to be considered a match to that criterion. Only contracts which are Enabled in Component Configuration will be evaluated for matching. |
|||
| ContractIdType |
"ContractId" |
||
| ContractSourceName |
NULL (use source of the package) |
Received Claim Load
| ContractId |
|
||
|
This column is populated based on the contracts configured in ContractDim Component Configuration. Claims that are associated directly to value-based program records in Chronicles make use of the bridge to associate claims to contracts. Remaining claims will match to the most specific possible contract, based on the contract's configured Managed Care criteria. When evaluating contracts for matching, precedence is given to contracts for which Managed Care Employer Group Epic ID is specified, followed by contracts for which Managed Care Division Epic ID is specified, followed by contracts for which Managed Care Corporation Epic ID is specified, followed by contracts for which Managed Care Benefit Plan Epic ID is specified, followed by contracts for which Managed Care Line of Business Epic ID is specified, followed by contracts for which Managed Care Payor Epic ID is specified, followed by contracts for which Managed Care Business Segment Epic ID is specified. In order to match to a contract, the claim must match to a value in all specified Managed Care criteria for that contract. If multiple values are specified for a particular Managed Care criterion, the claim need only match to one of the specified values in order to be considered a match to that criterion. Only contracts which are Enabled in Component Configuration will be evaluated for matching. |
|||
| ContractIdType |
"ContractId" |
||
| ContractSourceName |
NULL (use source of the package) |
Received Pharmacy Claim Load
| ContractId |
|
||
|
This column is populated based on the contracts configured in ContractDim Component Configuration. Claims that are associated directly to value-based program records in Chronicles make use of the bridge to associate claims to contracts. Remaining claims will match to the most specific possible contract, based on the contract's configured Managed Care criteria. When evaluating contracts for matching, precedence is given to contracts for which Managed Care Business Segment Epic ID is specified. In order to match to a contract, the claim must match to a value in all specified Managed Care criteria for that contract. If multiple values are specified for a particular Managed Care criterion, the claim need only match to one of the specified values in order to be considered a match to that criterion. Only contracts which are Enabled in Component Configuration will be evaluated for matching. |
|||
| ContractIdType |
"ContractId" |
||
| ContractSourceName |
NULL (use source of the package) |
ContractComboKey
: integerAll contracts associated with the claim
Properties
- Data type
- integer
- SQL Server data type
- bigint
- Allows null
- No
- Default value
- -1
- Delete value
- -3
Data Lineage for Each Package
CMS ACO Part A Files Load
| ContractComboId |
|
||
| ContractComboIdType |
"MsspClaimUniqueId" |
CMS ACO Part B DME File Load
| ContractComboId |
|
||
| ContractComboIdType |
"MsspClaimUniqueId" |
CMS ACO Part B Physicians File Load
| ContractComboId |
|
||
| ContractComboIdType |
"MsspClaimUniqueId" |
CMS ACO Part D Prescription Drug File Load
| ContractComboId |
|
||
| ContractComboIdType |
"MsspClaimUniqueId" |
CMS CJR DME Claim Load
| ContractComboId |
1 |
| ContractComboIdType |
CmsCjrContractId |
CMS CJR Home Health Claim Load
| ContractComboId |
1 |
| ContractComboIdType |
CmsCjrContractId |
CMS CJR Hospice Claim Load
| ContractComboId |
1 |
| ContractComboIdType |
CmsCjrContractId |
CMS CJR Inpatient Claim Load
| ContractComboId |
1 |
| ContractComboIdType |
CmsCjrContractId |
CMS CJR Outpatient Claim Load
| ContractComboId |
1 |
| ContractComboIdType |
CmsCjrContractId |
CMS CJR Part B Claim Load
| ContractComboId |
1 |
| ContractComboIdType |
CmsCjrContractId |
CMS CJR Skilled Nursing Facility Claim Load
| ContractComboId |
1 |
| ContractComboIdType |
CmsCjrContractId |
Data Aggregation Medical Claim Load
| ContractComboId |
|
||
| ContractComboIdType |
"EpicClaimInformationId" |
Data Aggregation Pharmacy Claim Load
| ContractComboId |
|
||
| ContractComboIdType |
Externally Adjudicated Medical Claim Load
| ContractComboId |
|
||
|
This column is populated based on either the contracts specified in claim record directly or the contracts configured in ContractDim Component Configuration. Claims that are associated directly to value-based program records in Chronicles will be associated with the contracts created from the value-based program records. For the configuration, the remaining claims will match to the most specific possible contract, based on the contract's configured Managed Care criteria. When evaluating contracts for matching, precedence is given to contracts for which Managed Care Employer Group Epic ID is specified, followed by contracts for which Managed Care Division Epic ID is specified, followed by contracts for which Managed Care Corporation Epic ID is specified, followed by contracts for which Managed Care Benefit Plan Epic ID is specified, followed by contracts for which Managed Care Line of Business Epic ID is specified, followed by contracts for which Managed Care Payor Epic ID is specified, followed by contracts for which Managed Care Business Segment Epic ID is specified. In order to match to a contract, the claim must match to a value in all specified Managed Care criteria for that contract. If multiple values are specified for a particular Managed Care criterion, the claim need only match to one of the specified values in order to be considered a match to that criterion. Only contracts which are Enabled in Component Configuration will be evaluated for matching. |
|||
| ContractComboIdType |
"EpicClaimInformationId" |
Externally Adjudicated Pharmacy Claim Load
| ContractComboId |
|
||
|
This column is populated based on either the contracts specified in claim record directly or the contracts configured in ContractDim Component Configuration. Claims that are associated directly to value-based program records in Chronicles will be associated with the contracts created from the value-based program records. For the configuration, the remaining claims will match to the most specific possible contract, based on the contract's configured Managed Care criteria. When evaluating contracts for matching, precedence is given to contracts for which Managed Care Employer Group Epic ID is specified, followed by contracts for which Managed Care Business Segment Epic ID is specified. In order to match to a contract, the claim must match to a value in all specified Managed Care criteria for that contract. If multiple values are specified for a particular Managed Care criterion, the claim need only match to one of the specified values in order to be considered a match to that criterion. Only contracts which are Enabled in Component Configuration will be evaluated for matching. |
|||
| ContractComboIdType |
"EpicPharmacyClaimInformationId" |
Payer System Medical Claim Load
| ContractComboId |
|
||
| ContractComboIdType |
"EpicClaimInformationId" |
Payer System Pharmacy Claim Load
| ContractComboId |
|
||
| ContractComboIdType |
Received Claim Load
| ContractComboId |
|
||
|
This column is populated based on either the contracts specified in claim record directly or the contracts configured in ContractDim Component Configuration. Claims that are associated directly to value-based program records in Chronicles will be associated with the contracts created from the value-based program records. For the configuration, the remaining claims will match to the most specific possible contract, based on the contract's configured Managed Care criteria. When evaluating contracts for matching, precedence is given to contracts for which Managed Care Employer Group Epic ID is specified, followed by contracts for which Managed Care Division Epic ID is specified, followed by contracts for which Managed Care Corporation Epic ID is specified, followed by contracts for which Managed Care Benefit Plan Epic ID is specified, followed by contracts for which Managed Care Line of Business Epic ID is specified, followed by contracts for which Managed Care Payor Epic ID is specified, followed by contracts for which Managed Care Business Segment Epic ID is specified. In order to match to a contract, the claim must match to a value in all specified Managed Care criteria for that contract. If multiple values are specified for a particular Managed Care criterion, the claim need only match to one of the specified values in order to be considered a match to that criterion. Only contracts which are Enabled in Component Configuration will be evaluated for matching. |
|||
| ContractComboIdType |
"EpicClaimInformationId" |
Received Pharmacy Claim Load
| ContractComboId |
|
||
|
This column is populated based on either the contracts specified in claim record directly or the contracts configured in ContractDim Component Configuration. Claims that are associated directly to value-based program records in Chronicles will be associated with the contracts created from the value-based program records. For the configuration, the remaining claims will match to the most specific possible contract, based on the contract's configured Managed Care criteria. When evaluating contracts for matching, precedence is given to contracts for which Managed Care Employer Group Epic ID is specified, followed by contracts for which Managed Care Business Segment Epic ID is specified. In order to match to a contract, the claim must match to a value in all specified Managed Care criteria for that contract. If multiple values are specified for a particular Managed Care criterion, the claim need only match to one of the specified values in order to be considered a match to that criterion. Only contracts which are Enabled in Component Configuration will be evaluated for matching. |
|||
| ContractComboIdType |
"EpicPharmacyClaimInformationId" |
ContractComboIdTypeId
: integerThe IdTypeId corresponding to the ContractBridge lookup
Properties
- Data type
- integer
- SQL Server data type
- smallint
- Allows null
- Yes
ContractComboId
: stringThe Id corresponding to the ContractBridge lookup
Properties
- Data type
- string
- SQL Server data type
- nvarchar(50)
- Allows null
- Yes
- Delete value
- empty string
Data Lineage for Each Package
CMS ACO Part A Files Load
| ContractComboId |
|
||
CMS ACO Part B DME File Load
| ContractComboId |
|
||
CMS ACO Part B Physicians File Load
| ContractComboId |
|
||
CMS ACO Part D Prescription Drug File Load
| ContractComboId |
|
||
CMS CJR DME Claim Load
| ContractComboId |
1 |
CMS CJR Home Health Claim Load
| ContractComboId |
1 |
CMS CJR Hospice Claim Load
| ContractComboId |
1 |
CMS CJR Inpatient Claim Load
| ContractComboId |
1 |
CMS CJR Outpatient Claim Load
| ContractComboId |
1 |
CMS CJR Part B Claim Load
| ContractComboId |
1 |
CMS CJR Skilled Nursing Facility Claim Load
| ContractComboId |
1 |
Data Aggregation Medical Claim Load
| ContractComboId |
|
||
Data Aggregation Pharmacy Claim Load
| ContractComboId |
|
||
Externally Adjudicated Medical Claim Load
| ContractComboId |
|
||
|
This column is populated based on either the contracts specified in claim record directly or the contracts configured in ContractDim Component Configuration. Claims that are associated directly to value-based program records in Chronicles will be associated with the contracts created from the value-based program records. For the configuration, the remaining claims will match to the most specific possible contract, based on the contract's configured Managed Care criteria. When evaluating contracts for matching, precedence is given to contracts for which Managed Care Employer Group Epic ID is specified, followed by contracts for which Managed Care Division Epic ID is specified, followed by contracts for which Managed Care Corporation Epic ID is specified, followed by contracts for which Managed Care Benefit Plan Epic ID is specified, followed by contracts for which Managed Care Line of Business Epic ID is specified, followed by contracts for which Managed Care Payor Epic ID is specified, followed by contracts for which Managed Care Business Segment Epic ID is specified. In order to match to a contract, the claim must match to a value in all specified Managed Care criteria for that contract. If multiple values are specified for a particular Managed Care criterion, the claim need only match to one of the specified values in order to be considered a match to that criterion. Only contracts which are Enabled in Component Configuration will be evaluated for matching. |
Externally Adjudicated Pharmacy Claim Load
| ContractComboId |
|
||
|
This column is populated based on either the contracts specified in claim record directly or the contracts configured in ContractDim Component Configuration. Claims that are associated directly to value-based program records in Chronicles will be associated with the contracts created from the value-based program records. For the configuration, the remaining claims will match to the most specific possible contract, based on the contract's configured Managed Care criteria. When evaluating contracts for matching, precedence is given to contracts for which Managed Care Employer Group Epic ID is specified, followed by contracts for which Managed Care Business Segment Epic ID is specified. In order to match to a contract, the claim must match to a value in all specified Managed Care criteria for that contract. If multiple values are specified for a particular Managed Care criterion, the claim need only match to one of the specified values in order to be considered a match to that criterion. Only contracts which are Enabled in Component Configuration will be evaluated for matching. |
Payer System Medical Claim Load
| ContractComboId |
|
||
Payer System Pharmacy Claim Load
| ContractComboId |
|
||
Received Claim Load
| ContractComboId |
|
||
|
This column is populated based on either the contracts specified in claim record directly or the contracts configured in ContractDim Component Configuration. Claims that are associated directly to value-based program records in Chronicles will be associated with the contracts created from the value-based program records. For the configuration, the remaining claims will match to the most specific possible contract, based on the contract's configured Managed Care criteria. When evaluating contracts for matching, precedence is given to contracts for which Managed Care Employer Group Epic ID is specified, followed by contracts for which Managed Care Division Epic ID is specified, followed by contracts for which Managed Care Corporation Epic ID is specified, followed by contracts for which Managed Care Benefit Plan Epic ID is specified, followed by contracts for which Managed Care Line of Business Epic ID is specified, followed by contracts for which Managed Care Payor Epic ID is specified, followed by contracts for which Managed Care Business Segment Epic ID is specified. In order to match to a contract, the claim must match to a value in all specified Managed Care criteria for that contract. If multiple values are specified for a particular Managed Care criterion, the claim need only match to one of the specified values in order to be considered a match to that criterion. Only contracts which are Enabled in Component Configuration will be evaluated for matching. |
Received Pharmacy Claim Load
| ContractComboId |
|
||
|
This column is populated based on either the contracts specified in claim record directly or the contracts configured in ContractDim Component Configuration. Claims that are associated directly to value-based program records in Chronicles will be associated with the contracts created from the value-based program records. For the configuration, the remaining claims will match to the most specific possible contract, based on the contract's configured Managed Care criteria. When evaluating contracts for matching, precedence is given to contracts for which Managed Care Employer Group Epic ID is specified, followed by contracts for which Managed Care Business Segment Epic ID is specified. In order to match to a contract, the claim must match to a value in all specified Managed Care criteria for that contract. If multiple values are specified for a particular Managed Care criterion, the claim need only match to one of the specified values in order to be considered a match to that criterion. Only contracts which are Enabled in Component Configuration will be evaluated for matching. |
ContractNumericId
: numberThe NumericId corresponding to the ContractBridge lookup. If this column is populated, then ContractComboId will not be populated. Cannot and should not be populated by packages.
Properties
- Data type
- number
- SQL Server data type
- numeric(38,0)
- Allows null
- Yes
LineOfBusinessKey
: integerLine of business associated with the claim
Properties
- Data type
- integer
- SQL Server data type
- bigint
- Allows null
- No
- Default value
- -1
- Delete value
- -3
Data Lineage for Each Package
CMS ACO Part A Files Load
| LineOfBusinessId |
|
||
|
Line of business as configured through interface configuration in Chronicles |
|||
| LineOfBusinessIdType |
"EpicLineOfBusinessId" |
CMS ACO Part B DME File Load
| LineOfBusinessId |
|
||
|
Line of business as configured through interface configuration in Chronicles |
|||
| LineOfBusinessIdType |
"EpicLineOfBusinessId" |
CMS ACO Part B Physicians File Load
| LineOfBusinessId |
|
||
|
Line of business as configured through interface configuration in Chronicles |
|||
| LineOfBusinessIdType |
"EpicLineOfBusinessId" |
CMS ACO Part D Prescription Drug File Load
| LineOfBusinessId |
|
||
|
Line of business as configured through interface configuration in Chronicles |
|||
| LineOfBusinessIdType |
"EpicLineOfBusinessId" |
CMS CJR DME Claim Load
| LineOfBusinessId | |
| LineOfBusinessIdType |
CMS CJR Home Health Claim Load
| LineOfBusinessId | |
| LineOfBusinessIdType |
CMS CJR Hospice Claim Load
| LineOfBusinessId | |
| LineOfBusinessIdType |
CMS CJR Inpatient Claim Load
| LineOfBusinessId | |
| LineOfBusinessIdType |
CMS CJR Outpatient Claim Load
| LineOfBusinessId | |
| LineOfBusinessIdType |
CMS CJR Part B Claim Load
| LineOfBusinessId | |
| LineOfBusinessIdType |
CMS CJR Skilled Nursing Facility Claim Load
| LineOfBusinessId | |
| LineOfBusinessIdType |
Data Aggregation Medical Claim Load
| LineOfBusinessId |
|
||
| LineOfBusinessIdType |
"EpicLineOfBusinessId" |
Data Aggregation Pharmacy Claim Load
| LineOfBusinessId |
|
||
| LineOfBusinessIdType |
"EpicLineOfBusinessId" |
Externally Adjudicated Medical Claim Load
| LineOfBusinessId |
|
||
| LineOfBusinessIdType |
"EpicLineOfBusinessId" |
Externally Adjudicated Pharmacy Claim Load
| LineOfBusinessId |
NULL |
| LineOfBusinessIdType |
"NotApplicable" |
Payer System Medical Claim Load
| LineOfBusinessId |
|
||
| LineOfBusinessIdType |
"EpicLineOfBusinessId" |
Payer System Pharmacy Claim Load
| LineOfBusinessId |
|
||
| LineOfBusinessIdType |
"EpicLineOfBusinessId" |
Received Claim Load
| LineOfBusinessId |
|
||
| LineOfBusinessIdType |
"EpicLineOfBusinessId" |
Received Pharmacy Claim Load
| LineOfBusinessId |
NULL |
| LineOfBusinessIdType |
"NotApplicable" |
OwningBusinessSegmentKey
: integerPrimary business segment for the claim
Properties
- Data type
- integer
- SQL Server data type
- bigint
- Allows null
- No
- Default value
- -1
- Delete value
- -3
Data Lineage for Each Package
CMS ACO Part A Files Load
| OwningBusinessSegmentId |
NULL |
| OwningBusinessSegmentIdType |
"NotApplicable" |
CMS ACO Part B DME File Load
| OwningBusinessSegmentId |
NULL |
| OwningBusinessSegmentIdType |
"NotApplicable" |
CMS ACO Part B Physicians File Load
| OwningBusinessSegmentId |
NULL |
| OwningBusinessSegmentIdType |
"NotApplicable" |
CMS ACO Part D Prescription Drug File Load
| OwningBusinessSegmentId |
NULL |
| OwningBusinessSegmentIdType |
"NotApplicable" |
CMS CJR DME Claim Load
| OwningBusinessSegmentId |
NULL |
| OwningBusinessSegmentIdType |
NotApplicable |
CMS CJR Home Health Claim Load
| OwningBusinessSegmentId |
NULL |
| OwningBusinessSegmentIdType |
NotApplicable |
CMS CJR Hospice Claim Load
| OwningBusinessSegmentId |
NULL |
| OwningBusinessSegmentIdType |
NotApplicable |
CMS CJR Inpatient Claim Load
| OwningBusinessSegmentId |
NULL |
| OwningBusinessSegmentIdType |
NotApplicable |
CMS CJR Outpatient Claim Load
| OwningBusinessSegmentId |
NULL |
| OwningBusinessSegmentIdType |
NotApplicable |
CMS CJR Part B Claim Load
| OwningBusinessSegmentId |
NULL |
| OwningBusinessSegmentIdType |
NotApplicable |
CMS CJR Skilled Nursing Facility Claim Load
| OwningBusinessSegmentId |
NULL |
| OwningBusinessSegmentIdType |
NotApplicable |
Data Aggregation Medical Claim Load
| OwningBusinessSegmentId |
|
||
| OwningBusinessSegmentIdType |
|
||
|
"EpicFacilityProfileId" |
Data Aggregation Pharmacy Claim Load
| OwningBusinessSegmentId |
|
||
| OwningBusinessSegmentIdType |
"EpicFacilityProfileId" |
Externally Adjudicated Medical Claim Load
| OwningBusinessSegmentId |
|
||
| OwningBusinessSegmentIdType |
"EpicFacilityProfileId" |
Externally Adjudicated Pharmacy Claim Load
| OwningBusinessSegmentId |
|
||
| OwningBusinessSegmentIdType |
"EpicFacilityProfileId" |
Payer System Medical Claim Load
| OwningBusinessSegmentId |
|
||
| OwningBusinessSegmentIdType |
"EpicFacilityProfileId" |
Payer System Pharmacy Claim Load
| OwningBusinessSegmentId |
|
||
| OwningBusinessSegmentIdType |
"EpicFacilityProfileId" |
Received Claim Load
| OwningBusinessSegmentId |
|
||
| OwningBusinessSegmentIdType |
"EpicFacilityProfileId" |
Received Pharmacy Claim Load
| OwningBusinessSegmentId |
|
||
| OwningBusinessSegmentIdType |
"EpicFacilityProfileId" |
OwningServiceAreaKey
: integerPrimary service area on the claim
Properties
- Data type
- integer
- SQL Server data type
- bigint
- Allows null
- No
- Default value
- -1
- Delete value
- -3
Data Lineage for Each Package
CMS ACO Part A Files Load
| OwningServiceAreaId |
NULL |
| OwningServiceAreaIdType |
"NotApplicable" |
CMS ACO Part B DME File Load
| OwningServiceAreaId |
NULL |
| OwningServiceAreaIdType |
"NotApplicable" |
CMS ACO Part B Physicians File Load
| OwningServiceAreaId |
NULL |
| OwningServiceAreaIdType |
"NotApplicable" |
CMS ACO Part D Prescription Drug File Load
| OwningServiceAreaId |
NULL |
| OwningServiceAreaIdType |
"NotApplicable" |
CMS CJR DME Claim Load
| OwningServiceAreaId |
NULL |
| OwningServiceAreaIdType |
NotApplicable |
CMS CJR Home Health Claim Load
| OwningServiceAreaId |
NULL |
| OwningServiceAreaIdType |
NotApplicable |
CMS CJR Hospice Claim Load
| OwningServiceAreaId |
NULL |
| OwningServiceAreaIdType |
NotApplicable |
CMS CJR Inpatient Claim Load
| OwningServiceAreaId |
NULL |
| OwningServiceAreaIdType |
NotApplicable |
CMS CJR Outpatient Claim Load
| OwningServiceAreaId |
NULL |
| OwningServiceAreaIdType |
NotApplicable |
CMS CJR Part B Claim Load
| OwningServiceAreaId |
NULL |
| OwningServiceAreaIdType |
NotApplicable |
CMS CJR Skilled Nursing Facility Claim Load
| OwningServiceAreaId |
NULL |
| OwningServiceAreaIdType |
NotApplicable |
Data Aggregation Medical Claim Load
| OwningServiceAreaId |
|
||
| OwningServiceAreaIdType |
|
||
|
"EpicFacilityProfileId" |
Data Aggregation Pharmacy Claim Load
| OwningServiceAreaId |
|
||
| OwningServiceAreaIdType |
"EpicFacilityProfileId" |
Externally Adjudicated Medical Claim Load
| OwningServiceAreaId |
|
||
| OwningServiceAreaIdType |
"EpicFacilityProfileId" |
Externally Adjudicated Pharmacy Claim Load
| OwningServiceAreaId |
|
||
| OwningServiceAreaIdType |
"EpicFacilityProfileId" |
Payer System Medical Claim Load
| OwningServiceAreaId |
|
||
| OwningServiceAreaIdType |
"EpicFacilityProfileId" |
Payer System Pharmacy Claim Load
| OwningServiceAreaId |
|
||
| OwningServiceAreaIdType |
"EpicFacilityProfileId" |
Received Claim Load
| OwningServiceAreaId |
|
||
| OwningServiceAreaIdType |
"EpicFacilityProfileId" |
Received Pharmacy Claim Load
| OwningServiceAreaId |
|
||
| OwningServiceAreaIdType |
"EpicFacilityProfileId" |
ServiceAreaComboKey
: integerAll associated service areas and business segments for this received claim. For claims not loaded from Clarity, it is calculated from ClaimSharingConfigurationFact.
Properties
- Data type
- integer
- SQL Server data type
- bigint
- Allows null
- No
- Default value
- -1
- Delete value
- -3
Data Lineage for Each Package
CMS ACO Part A Files Load
| ServiceAreaComboId |
Epic.ConfigurationInfo_PlanAttributeConfiguration.EligibilityBusinessSegmentDefaultId Business segment configured through interface configuration in Chronicles |
| ServiceAreaComboIdType |
"EpicFacilityProfileId" |
CMS ACO Part B DME File Load
| ServiceAreaComboId |
Epic.ConfigurationInfo_PlanAttributeConfiguration.EligibilityBusinessSegmentDefaultId Business segment configured through interface configuration in Chronicles |
| ServiceAreaComboIdType |
"EpicFacilityProfileId" |
CMS ACO Part B Physicians File Load
| ServiceAreaComboId |
Epic.ConfigurationInfo_PlanAttributeConfiguration.EligibilityBusinessSegmentDefaultId Business segment configured through interface configuration in Chronicles |
| ServiceAreaComboIdType |
"EpicFacilityProfileId" |
CMS ACO Part D Prescription Drug File Load
| ServiceAreaComboId |
Epic.ConfigurationInfo_PlanAttributeConfiguration.EligibilityBusinessSegmentDefaultId Business segment configured through interface configuration in Chronicles |
| ServiceAreaComboIdType |
"EpicFacilityProfileId" |
CMS CJR DME Claim Load
| ServiceAreaComboId |
NULL |
| ServiceAreaComboIdType |
NotApplicable |
CMS CJR Home Health Claim Load
| ServiceAreaComboId |
NULL |
| ServiceAreaComboIdType |
NotApplicable |
CMS CJR Hospice Claim Load
| ServiceAreaComboId |
NULL |
| ServiceAreaComboIdType |
NotApplicable |
CMS CJR Inpatient Claim Load
| ServiceAreaComboId |
NULL |
| ServiceAreaComboIdType |
NotApplicable |
CMS CJR Outpatient Claim Load
| ServiceAreaComboId |
NULL |
| ServiceAreaComboIdType |
NotApplicable |
CMS CJR Part B Claim Load
| ServiceAreaComboId |
NULL |
| ServiceAreaComboIdType |
NotApplicable |
CMS CJR Skilled Nursing Facility Claim Load
| ServiceAreaComboId |
NULL |
| ServiceAreaComboIdType |
NotApplicable |
Data Aggregation Medical Claim Load
| ServiceAreaComboId |
|
||
| ServiceAreaComboIdType |
"EpicClaimInformationId" |
Data Aggregation Pharmacy Claim Load
| ServiceAreaComboId |
|
||
| ServiceAreaComboIdType |
"EpicPharmacyClaimInformationId" |
Externally Adjudicated Medical Claim Load
| ServiceAreaComboId |
|
||
| ServiceAreaComboIdType |
"EpicClaimInformationId" |
Externally Adjudicated Pharmacy Claim Load
| ServiceAreaComboId |
|
||
| ServiceAreaComboIdType |
"EpicPharmacyClaimInformationId" |
Payer System Medical Claim Load
| ServiceAreaComboId |
|
||
| ServiceAreaComboIdType |
"EpicClaimInformationId" |
Payer System Pharmacy Claim Load
| ServiceAreaComboId |
|
||
| ServiceAreaComboIdType |
"EpicPharmacyClaimInformationId" |
Received Claim Load
| ServiceAreaComboId |
|
||
| ServiceAreaComboIdType |
"EpicClaimInformationId" |
Received Pharmacy Claim Load
| ServiceAreaComboId |
|
||
| ServiceAreaComboIdType |
"EpicPharmacyClaimInformationId" |
ServiceAreaComboIdTypeId
: integerThe IdTypeId corresponding to the DepartmentBridge lookup
Properties
- Data type
- integer
- SQL Server data type
- smallint
- Allows null
- Yes
ServiceAreaNumericId
: numberThe NumericId corresponding to the DepartmentBridge lookup. If this column is populated, then ComboId will not be populated. Cannot and should not be populated by packages.
Properties
- Data type
- number
- SQL Server data type
- numeric(38,0)
- Allows null
- Yes
ServiceAreaComboId
: stringThe Id corresponding to the DepartmentBridge lookup
Properties
- Data type
- string
- SQL Server data type
- nvarchar(50)
- Allows null
- Yes
- Delete value
- empty string
Data Lineage for Each Package
CMS ACO Part A Files Load
| ServiceAreaComboId |
Epic.ConfigurationInfo_PlanAttributeConfiguration.EligibilityBusinessSegmentDefaultId Business segment configured through interface configuration in Chronicles |
CMS ACO Part B DME File Load
| ServiceAreaComboId |
Epic.ConfigurationInfo_PlanAttributeConfiguration.EligibilityBusinessSegmentDefaultId Business segment configured through interface configuration in Chronicles |
CMS ACO Part B Physicians File Load
| ServiceAreaComboId |
Epic.ConfigurationInfo_PlanAttributeConfiguration.EligibilityBusinessSegmentDefaultId Business segment configured through interface configuration in Chronicles |
CMS ACO Part D Prescription Drug File Load
| ServiceAreaComboId |
Epic.ConfigurationInfo_PlanAttributeConfiguration.EligibilityBusinessSegmentDefaultId Business segment configured through interface configuration in Chronicles |
CMS CJR DME Claim Load
| ServiceAreaComboId |
NULL |
CMS CJR Home Health Claim Load
| ServiceAreaComboId |
NULL |
CMS CJR Hospice Claim Load
| ServiceAreaComboId |
NULL |
CMS CJR Inpatient Claim Load
| ServiceAreaComboId |
NULL |
CMS CJR Outpatient Claim Load
| ServiceAreaComboId |
NULL |
CMS CJR Part B Claim Load
| ServiceAreaComboId |
NULL |
CMS CJR Skilled Nursing Facility Claim Load
| ServiceAreaComboId |
NULL |
Data Aggregation Medical Claim Load
| ServiceAreaComboId |
|
||
Data Aggregation Pharmacy Claim Load
| ServiceAreaComboId |
|
||
Externally Adjudicated Medical Claim Load
| ServiceAreaComboId |
|
||
Externally Adjudicated Pharmacy Claim Load
| ServiceAreaComboId |
|
||
Payer System Medical Claim Load
| ServiceAreaComboId |
|
||
Payer System Pharmacy Claim Load
| ServiceAreaComboId |
|
||
Received Claim Load
| ServiceAreaComboId |
|
||
Received Pharmacy Claim Load
| ServiceAreaComboId |
|
||
EndDateKey
: integerLast date services were rendered to the patient associated with the claim
Properties
- Data type
- integer
- SQL Server data type
- bigint
- Allows null
- No
- Default value
- -1
- Delete value
- -3
Data Lineage for Each Package
CMS ACO Part A Files Load
| EndDate |
|
||
|
If CLM_THRU_DT < 1/1/1753 or CLM_THRU_DT = 12/31/9999 then NULL Otherwise CLM_THRU_DT |
CMS ACO Part B DME File Load
| EndDate |
|
||
|
If CLM_THRU_DT < 1/1/1753 or CLM_THRU_DT = 12/31/9999 then NULL Otherwise CLM_THRU_DT |
CMS ACO Part B Physicians File Load
| EndDate |
|
||
|
If CLM_THRU_DT < 1/1/1753 or CLM_THRU_DT = 12/31/9999 then NULL Otherwise CLM_THRU_DT |
CMS ACO Part D Prescription Drug File Load
| EndDate |
|
||
|
If CLM_LINE_FROM_DT < 1/1/1753 or CLM_LINE_FROM_DT = 12/31/9999 then NULL Otherwise CLM_LINE_FROM_DT |
CMS CJR DME Claim Load
| EndDate |
|
||
CMS CJR Home Health Claim Load
| EndDate |
|
||
CMS CJR Hospice Claim Load
| EndDate |
|
||
CMS CJR Inpatient Claim Load
| EndDate |
|
||
CMS CJR Outpatient Claim Load
| EndDate |
|
||
CMS CJR Part B Claim Load
| EndDate |
|
||
CMS CJR Skilled Nursing Facility Claim Load
| EndDate |
|
||
Data Aggregation Medical Claim Load
| EndDate |
|
||||
|
Minimum of STMT_COV_TO_DATE - Time Zone: Unspecified and SERVICE_END_DATE - Time Zone: Unspecified |
Data Aggregation Pharmacy Claim Load
| EndDate |
|
||
Externally Adjudicated Medical Claim Load
| EndDate |
|
||||
|
Minimum of STMT_COV_TO_DATE - Time Zone: Unspecified and SERVICE_END_DATE - Time Zone: Unspecified |
Externally Adjudicated Pharmacy Claim Load
| EndDate |
|
||
Payer System Medical Claim Load
| EndDate |
|
||||
|
Minimum of STMT_COV_TO_DATE - Time Zone: Unspecified and SERVICE_END_DATE - Time Zone: Unspecified |
Payer System Pharmacy Claim Load
| EndDate |
|
||
Received Claim Load
| EndDate |
|
||||
|
Minimum of STMT_COV_TO_DATE - Time Zone: Unspecified and SERVICE_END_DATE - Time Zone: Unspecified |
Received Pharmacy Claim Load
| EndDate |
|
||
AdmissionDateKey
: integerDate the patient was admitted
Properties
- Data type
- integer
- SQL Server data type
- bigint
- Allows null
- No
- Default value
- -1
- Delete value
- -3
Data Lineage for Each Package
CMS ACO Part A Files Load
| AdmissionInstant |
|
||
CMS ACO Part B DME File Load
| AdmissionInstant |
NULL |
CMS ACO Part B Physicians File Load
| AdmissionInstant |
NULL |
CMS ACO Part D Prescription Drug File Load
| AdmissionInstant |
NULL |
CMS CJR DME Claim Load
| AdmissionInstant |
NULL |
CMS CJR Home Health Claim Load
| AdmissionInstant |
NULL |
CMS CJR Hospice Claim Load
| AdmissionInstant |
NULL |
CMS CJR Inpatient Claim Load
| AdmissionInstant |
|
||
CMS CJR Outpatient Claim Load
| AdmissionInstant |
NULL |
CMS CJR Part B Claim Load
| AdmissionInstant |
NULL |
CMS CJR Skilled Nursing Facility Claim Load
| AdmissionInstant |
|
||
Data Aggregation Medical Claim Load
| AdmissionInstant |
|
||
Externally Adjudicated Medical Claim Load
| AdmissionInstant |
|
||
Payer System Medical Claim Load
| AdmissionInstant |
|
||
Received Claim Load
| AdmissionInstant |
|
||
DischargeDateKey
: integerDate the patient was discharged
Properties
- Data type
- integer
- SQL Server data type
- bigint
- Allows null
- No
- Default value
- -1
- Delete value
- -3
Data Lineage for Each Package
CMS ACO Part A Files Load
| DischargeInstant |
NULL |
CMS ACO Part B DME File Load
| DischargeInstant |
NULL |
CMS ACO Part B Physicians File Load
| DischargeInstant |
NULL |
CMS ACO Part D Prescription Drug File Load
| DischargeInstant |
NULL |
CMS CJR DME Claim Load
| DischargeInstant |
NULL |
CMS CJR Home Health Claim Load
| DischargeInstant |
NULL |
CMS CJR Hospice Claim Load
| DischargeInstant |
NULL |
CMS CJR Inpatient Claim Load
| DischargeInstant |
|
||
CMS CJR Outpatient Claim Load
| DischargeInstant |
NULL |
CMS CJR Part B Claim Load
| DischargeInstant |
NULL |
CMS CJR Skilled Nursing Facility Claim Load
| DischargeInstant |
|
||
Data Aggregation Medical Claim Load
| DischargeInstant |
|
||
Externally Adjudicated Medical Claim Load
| DischargeInstant |
|
||
Payer System Medical Claim Load
| DischargeInstant |
|
||
Received Claim Load
| DischargeInstant |
|
||||||||||
|
If DISCHARGE_DATE is not NULL then DISCHARGE_DATE Otherwise if there is at least one OCCUR_DATE where EXTERNAL_OCCUR_CODE = 42 then maximum of OCCUR_DATE where EXTERNAL_OCCUR_CODE = 42 Otherwise if there is at least one OCCUR_DATE where EXTERNAL_OCCUR_CODE = 36, 37, or 39 then maximum of OCCUR_DATE where EXTERNAL_OCCUR_CODE = 36, 37, or 39 Otherwise if TYPE_OF_BILL is not 3 or 4 digits or the last digit of TYPE_OF_BILL � 1 or 4 then NULL Otherwise if TYPE_OF_BILL is of format 011X, 018X, 021X, 028X, 041X, 065X, 066X, 084X, 086X, or 089X (leading 0 is optional) then STMT_COV_TO_DATE |
ClaimReceivedDateKey
: integerDate the claim was received
Properties
- Data type
- integer
- SQL Server data type
- bigint
- Allows null
- No
- Default value
- -1
- Delete value
- -3
Data Lineage for Each Package
CMS ACO Part A Files Load
| ClaimReceivedDate |
12/31/9999 |
CMS ACO Part B DME File Load
| ClaimReceivedDate |
12/31/9999 |
CMS ACO Part B Physicians File Load
| ClaimReceivedDate |
12/31/9999 |
CMS ACO Part D Prescription Drug File Load
| ClaimReceivedDate |
12/31/9999 |
CMS CJR DME Claim Load
| ClaimReceivedDate |
NULL |
CMS CJR Home Health Claim Load
| ClaimReceivedDate |
NULL |
CMS CJR Hospice Claim Load
| ClaimReceivedDate |
NULL |
CMS CJR Inpatient Claim Load
| ClaimReceivedDate |
NULL |
CMS CJR Outpatient Claim Load
| ClaimReceivedDate |
NULL |
CMS CJR Part B Claim Load
| ClaimReceivedDate |
NULL |
CMS CJR Skilled Nursing Facility Claim Load
| ClaimReceivedDate |
NULL |
Data Aggregation Medical Claim Load
| ClaimReceivedDate |
|
||
Data Aggregation Pharmacy Claim Load
| ClaimReceivedDate |
|
||
Externally Adjudicated Medical Claim Load
| ClaimReceivedDate |
|
||
Externally Adjudicated Pharmacy Claim Load
| ClaimReceivedDate |
|
||
Payer System Medical Claim Load
| ClaimReceivedDate |
|
||
Payer System Pharmacy Claim Load
| ClaimReceivedDate |
|
||
Received Claim Load
| ClaimReceivedDate |
|
||
|
Time Zone: Unspecified |
Received Pharmacy Claim Load
| ClaimReceivedDate |
|
||
CreatedDateKey
: integerThe date the claim was entered
Properties
- Data type
- integer
- SQL Server data type
- bigint
- Allows null
- No
- Default value
- -1
- Delete value
- -3
Data Lineage for Each Package
CMS ACO Part A Files Load
| CreatedDate |
NULL |
CMS ACO Part B DME File Load
| CreatedDate |
NULL |
CMS ACO Part B Physicians File Load
| CreatedDate |
NULL |
CMS ACO Part D Prescription Drug File Load
| CreatedDate |
NULL |
CMS CJR DME Claim Load
| CreatedDate |
NULL |
CMS CJR Home Health Claim Load
| CreatedDate |
NULL |
CMS CJR Hospice Claim Load
| CreatedDate |
NULL |
CMS CJR Inpatient Claim Load
| CreatedDate |
NULL |
CMS CJR Outpatient Claim Load
| CreatedDate |
NULL |
CMS CJR Part B Claim Load
| CreatedDate |
NULL |
CMS CJR Skilled Nursing Facility Claim Load
| CreatedDate |
NULL |
Received Claim Load
| CreatedDate |
|
||
CleanDeniedDateKey
: integerDate the claim reached a status of Clean or Denied
Properties
- Data type
- integer
- SQL Server data type
- bigint
- Allows null
- No
- Default value
- -1
- Delete value
- -3
Data Lineage for Each Package
CMS ACO Part A Files Load
| CleanDeniedDate |
NULL |
CMS ACO Part B DME File Load
| CleanDeniedDate |
NULL |
CMS ACO Part B Physicians File Load
| CleanDeniedDate |
NULL |
CMS ACO Part D Prescription Drug File Load
| CleanDeniedDate |
NULL |
CMS CJR DME Claim Load
| CleanDeniedDate |
NULL |
CMS CJR Home Health Claim Load
| CleanDeniedDate |
NULL |
CMS CJR Hospice Claim Load
| CleanDeniedDate |
NULL |
CMS CJR Inpatient Claim Load
| CleanDeniedDate |
NULL |
CMS CJR Outpatient Claim Load
| CleanDeniedDate |
NULL |
CMS CJR Part B Claim Load
| CleanDeniedDate |
NULL |
CMS CJR Skilled Nursing Facility Claim Load
| CleanDeniedDate |
NULL |
Received Claim Load
| CleanDeniedDate |
|
||||
|
If AP_CLAIM.STATUS_C is 3-Clean or 4-Denied then AP_CLAIM.STATUS_DATE Otherwise NULL |
InitialPaidInApDateKey
: integerDate the claim was paid within your Epic instance. If any checks were voided after the claim was fully processed in accounts payable, this is the latest posted date of a check before the earliest voided check date.
Properties
- Data type
- integer
- SQL Server data type
- bigint
- Allows null
- No
- Default value
- -1
- Delete value
- -3
Data Lineage for Each Package
CMS ACO Part A Files Load
| InitialPaidInApDate |
CMS ACO Part B DME File Load
| InitialPaidInApDate |
CMS ACO Part B Physicians File Load
| InitialPaidInApDate |
CMS ACO Part D Prescription Drug File Load
| InitialPaidInApDate |
CMS CJR DME Claim Load
| InitialPaidInApDate |
CMS CJR Home Health Claim Load
| InitialPaidInApDate |
CMS CJR Hospice Claim Load
| InitialPaidInApDate |
CMS CJR Inpatient Claim Load
| InitialPaidInApDate |
CMS CJR Outpatient Claim Load
| InitialPaidInApDate |
CMS CJR Part B Claim Load
| InitialPaidInApDate |
CMS CJR Skilled Nursing Facility Claim Load
| InitialPaidInApDate |
Data Aggregation Medical Claim Load
| InitialPaidInApDate |
Data Aggregation Pharmacy Claim Load
| InitialPaidInApDate |
Externally Adjudicated Medical Claim Load
| InitialPaidInApDate |
Externally Adjudicated Pharmacy Claim Load
| InitialPaidInApDate |
Payer System Medical Claim Load
| InitialPaidInApDate |
Payer System Pharmacy Claim Load
| InitialPaidInApDate |
Received Claim Load
| InitialPaidInApDate |
|
||||||||
|
If there exist any checks where AP_CLAIM_VOIDED_CHECK.AP_STS_C = 3-EOB Generated then the maximum of AP_CHECK.POST_DATE that is no later than the minimum of AP_CHECK.VOIDED_DATE of that set Otherwise AP_CHECK.POST_DATE for AP_CLAIM_2.PAID_CHECK_ID |
Received Pharmacy Claim Load
| InitialPaidInApDate |
PaidDateKey
: integerPost date of the check for the claim
Properties
- Data type
- integer
- SQL Server data type
- bigint
- Allows null
- No
- Default value
- -1
- Delete value
- -3
Data Lineage for Each Package
CMS ACO Part A Files Load
| PaidDate |
MsspPartAClaimsHeader.CLM_EFCTV_DT |
CMS ACO Part B DME File Load
| PaidDate |
MsspPartBDme.CLM_EFCTV_DT |
CMS ACO Part B Physicians File Load
| PaidDate |
MsspPartBPhysicians.CLM_EFCTV_DT |
CMS ACO Part D Prescription Drug File Load
| PaidDate |
MsspPartD.CLM_EFCTV_DT |
CMS CJR DME Claim Load
| PaidDate |
NULL |
CMS CJR Home Health Claim Load
| PaidDate |
NULL |
CMS CJR Hospice Claim Load
| PaidDate |
NULL |
CMS CJR Inpatient Claim Load
| PaidDate |
NULL |
CMS CJR Outpatient Claim Load
| PaidDate |
NULL |
CMS CJR Part B Claim Load
| PaidDate |
NULL |
CMS CJR Skilled Nursing Facility Claim Load
| PaidDate |
NULL |
Data Aggregation Medical Claim Load
| PaidDate |
|
||||
|
OTH_PAY_INFO_VAL_DT |
Data Aggregation Pharmacy Claim Load
| PaidDate |
|
||||
|
OTH_PAY_INFO_VAL_DT where OTH_PAY_INFO_TY_C = 1 and the claim does not have multiple different paid dates loaded |
Externally Adjudicated Medical Claim Load
| PaidDate |
|
||||
|
OTH_PAY_INFO_VAL_DT where OTH_PAY_INFO_TY_C = 1 and the claim does not have multiple different paid dates loaded |
Externally Adjudicated Pharmacy Claim Load
| PaidDate |
|
||||
|
OTH_PAY_INFO_VAL_DT where OTH_PAY_INFO_TY_C = 1 and the claim does not have multiple different paid dates loaded |
Payer System Medical Claim Load
| PaidDate |
|
||||
|
OTH_PAY_INFO_VAL_DT |
Payer System Pharmacy Claim Load
| PaidDate |
|
||||
|
OTH_PAY_INFO_VAL_DT where OTH_PAY_INFO_TY_C = 1 and the claim does not have multiple different paid dates loaded |
Received Claim Load
| PaidDate |
|
||||||||||
|
If POST_DATE is not null then POST_DATE Otherwise OTH_PAY_INFO_VAL_DT where OTH_PAY_INFO_TY_C = 1 and the claim does not have multiple different paid dates loaded |
Received Pharmacy Claim Load
| PaidDate |
|
||||
|
OTH_PAY_INFO_VAL_DT where OTH_PAY_INFO_TY_C = 1 and the claim does not have multiple different paid dates loaded |
PaymentDueDateKey
: integerDate by which the claim must be paid to avoid penalties or interest
Properties
- Data type
- integer
- SQL Server data type
- bigint
- Allows null
- No
- Default value
- -1
- Delete value
- -3
Data Lineage for Each Package
CMS ACO Part A Files Load
| PaymentDueDate |
NULL |
CMS ACO Part B DME File Load
| PaymentDueDate |
NULL |
CMS ACO Part B Physicians File Load
| PaymentDueDate |
NULL |
CMS ACO Part D Prescription Drug File Load
| PaymentDueDate |
NULL |
CMS CJR DME Claim Load
| PaymentDueDate |
NULL |
CMS CJR Home Health Claim Load
| PaymentDueDate |
NULL |
CMS CJR Hospice Claim Load
| PaymentDueDate |
NULL |
CMS CJR Inpatient Claim Load
| PaymentDueDate |
NULL |
CMS CJR Outpatient Claim Load
| PaymentDueDate |
NULL |
CMS CJR Part B Claim Load
| PaymentDueDate |
NULL |
CMS CJR Skilled Nursing Facility Claim Load
| PaymentDueDate |
NULL |
Received Claim Load
| PaymentDueDate |
|
||||
|
If TARGET_DATE is not null then TARGET_DATE Otherwise PAY_BY_DATE |
IsValidInSequenceThroughDateKey
: integerDate through which the given claim line would have been considered the final valid claim in a sequence. If a claim is the current claim in the sequence, it will have a date of 2173-12-31.
Properties
- Data type
- integer
- SQL Server data type
- bigint
- Allows null
- No
- Default value
- -1
- Delete value
- -3
AdjustmentType
: stringClaim adjustment type
Properties
- Data type
- string
- SQL Server data type
- nvarchar(50)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| AdjustmentType |
|
||||||||
|
If CLM_ADJSMT_TYPE_CD is NULL then "*Unspecified" Otherwise if Id is NULL where CategoryName = "ClaimAdjustmentTypeCode" then "*Unknown" Otherwise Name where CategoryName = "ClaimAdjustmentTypeCode" |
CMS ACO Part B DME File Load
| AdjustmentType |
|
||||||||
|
If CLM_ADJSMT_TYPE_CD is NULL then "*Unspecified" Otherwise if Id is NULL where CategoryName = "ClaimAdjustmentTypeCode" then "*Unknown" Otherwise Name where CategoryName = "ClaimAdjustmentTypeCode" |
CMS ACO Part B Physicians File Load
| AdjustmentType |
|
||||||||
|
If CLM_ADJSMT_TYPE_CD is NULL then "*Unspecified" Otherwise if Id is NULL where CategoryName = "ClaimAdjustmentTypeCode" then "*Unknown" Otherwise Name where CategoryName = "ClaimAdjustmentTypeCode" |
CMS ACO Part D Prescription Drug File Load
| AdjustmentType |
|
||||||||
|
If CLM_ADJSMT_TYPE_CD is NULL then "*Unspecified" Otherwise if Id is NULL where CategoryName = "ClaimAdjustmentTypeCode" then "*Unknown" Otherwise Name where CategoryName = "ClaimAdjustmentTypeCode" |
CMS CJR DME Claim Load
| AdjustmentType |
*Not Applicable |
CMS CJR Home Health Claim Load
| AdjustmentType |
*Not Applicable |
CMS CJR Hospice Claim Load
| AdjustmentType |
*Not Applicable |
CMS CJR Inpatient Claim Load
| AdjustmentType |
*Not Applicable |
CMS CJR Outpatient Claim Load
| AdjustmentType |
*Not Applicable |
CMS CJR Part B Claim Load
| AdjustmentType |
*Not Applicable |
CMS CJR Skilled Nursing Facility Claim Load
| AdjustmentType |
*Not Applicable |
Data Aggregation Medical Claim Load
| AdjustmentType |
|
||||||||||||
|
If ORIG_REV_CLM_ID is not NULL then "Cancellation" Otherwise if ORIG_OF_ADJUST_CLAIM_ID is not NULL then "Adjustment" Otherwise "Original" |
Data Aggregation Pharmacy Claim Load
| AdjustmentType |
|
||||||||
|
If ORIG_OF_REV_CLAIM_ID is not NULL then "Cancellation" Otherwise if ORIG_OF_ADJUST_CLAIM_ID is not NULL then "Adjustment" Otherwise "Original" |
Externally Adjudicated Medical Claim Load
| AdjustmentType |
|
||||||||||
|
If AP_CLAIM.ORIG_REV_CLM_ID is not NULL then "Cancellation" Otherwise if AP_CLAIM_2.CLM_FREQ_CODE_C = 8 then "Cancellation" Otherwise if the right-most character in AP_CLAIM.TYPE_OF_BILL = "8" then "Cancellation" Otherwise if AP_CLAIM.ORIG_ADJST_CLM_ID is not NULL then "Adjustment" Otherwise if AP_CLAIM_2.ORIG_ACT_ADJ_CLM_ID is not NULL then "Adjustment" Otherwise "Original" |
Externally Adjudicated Pharmacy Claim Load
| AdjustmentType |
|
||||
|
If ORIG_OF_REV_CLAIM_ID is not NULL then "Cancellation" Otherwise if ORIG_OF_ADJUST_CLAIM_ID is not NULL then "Adjustment" Otherwise "Original" |
Payer System Medical Claim Load
| AdjustmentType |
|
||||||||||||
|
If ORIG_REV_CLM_ID is not NULL then "Cancellation" Otherwise if ORIG_OF_ADJUST_CLAIM_ID is not NULL then "Adjustment" Otherwise "Original" |
Payer System Pharmacy Claim Load
| AdjustmentType |
|
||||||||
|
If ORIG_OF_REV_CLAIM_ID is not NULL then "Cancellation" Otherwise if ORIG_OF_ADJUST_CLAIM_ID is not NULL then "Adjustment" Otherwise "Original" |
Received Claim Load
| AdjustmentType |
|
||||||||||
|
If AP_CLAIM.ORIG_REV_CLM_ID is not NULL then "Cancellation" Otherwise if AP_CLAIM_2.CLM_FREQ_CODE_C = 8 then "Cancellation" Otherwise if the right-most character in AP_CLAIM.TYPE_OF_BILL = "8" then "Cancellation" Otherwise if AP_CLAIM.ORIG_ADJST_CLM_ID is not NULL then "Adjustment" Otherwise if AP_CLAIM_2.ORIG_ACT_ADJ_CLM_ID is not NULL then "Adjustment" Otherwise "Original" |
Received Pharmacy Claim Load
| AdjustmentType |
|
||||
|
If ORIG_OF_REV_CLAIM_ID is not NULL then "Cancellation" Otherwise if ORIG_OF_ADJUST_CLAIM_ID is not NULL then "Adjustment" Otherwise "Original" |
AdmissionTypeCode
: stringRecognized code for the type and priority of services associated with the claim
Properties
- Data type
- string
- SQL Server data type
- nvarchar(50)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| AdmissionTypeCode |
|
||
CMS ACO Part B DME File Load
| AdmissionTypeCode |
"*Not Applicable" |
CMS ACO Part B Physicians File Load
| AdmissionTypeCode |
"*Not Applicable" |
CMS ACO Part D Prescription Drug File Load
| AdmissionTypeCode |
"*Not Applicable" |
CMS CJR DME Claim Load
| AdmissionTypeCode |
*Not Applicable |
CMS CJR Home Health Claim Load
| AdmissionTypeCode |
*Not Applicable |
CMS CJR Hospice Claim Load
| AdmissionTypeCode |
*Not Applicable |
CMS CJR Inpatient Claim Load
| AdmissionTypeCode |
|
||
CMS CJR Outpatient Claim Load
| AdmissionTypeCode |
*Not Applicable |
CMS CJR Part B Claim Load
| AdmissionTypeCode |
*Not Applicable |
CMS CJR Skilled Nursing Facility Claim Load
| AdmissionTypeCode |
|
||
Data Aggregation Medical Claim Load
| AdmissionTypeCode |
|
||||
|
If ADMSN_TYP is not NULL then ADMSN_TYP Otherwise ADMISSION_TYPE_C |
Data Aggregation Pharmacy Claim Load
| AdmissionTypeCode |
"*Not Applicable" |
Externally Adjudicated Medical Claim Load
| AdmissionTypeCode |
|
||||
|
If ADMSN_TYP is not NULL then ADMSN_TYP Otherwise ADMISSION_TYPE_C |
Externally Adjudicated Pharmacy Claim Load
| AdmissionTypeCode |
"*Not Applicable" |
Payer System Medical Claim Load
| AdmissionTypeCode |
|
||||
|
If ADMSN_TYP is not NULL then ADMSN_TYP Otherwise ADMISSION_TYPE_C |
Payer System Pharmacy Claim Load
| AdmissionTypeCode |
"*Not Applicable" |
Received Claim Load
| AdmissionTypeCode |
|
||||
|
If ADMSN_TYP is not NULL then ADMSN_TYP Otherwise ADMISSION_TYPE_C |
Received Pharmacy Claim Load
| AdmissionTypeCode |
"*Not Applicable" |
AdmissionType
: stringType and priority of services associated with the claim
Properties
- Data type
- string
- SQL Server data type
- nvarchar(300)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| AdmissionType |
|
||||||||
|
If CLM_ADMSN_TYPE_CD is NULL then "*Unspecified" Otherwise if Id is NULL where CategoryName = "ClaimAdmissionTypeCode" then "*Unknown" Otherwise Name where CategoryName = "ClaimAdmissionTypeCode" |
CMS ACO Part B DME File Load
| AdmissionType |
"*Not Applicable" |
CMS ACO Part B Physicians File Load
| AdmissionType |
"*Not Applicable" |
CMS ACO Part D Prescription Drug File Load
| AdmissionType |
"*Not Applicable" |
CMS CJR DME Claim Load
| AdmissionType |
*Not Applicable |
CMS CJR Home Health Claim Load
| AdmissionType |
*Not Applicable |
CMS CJR Hospice Claim Load
| AdmissionType |
*Not Applicable |
CMS CJR Inpatient Claim Load
| AdmissionType |
|
||||||||
|
If TYPE_ADM is NULL then *Unspecified Otherwise if Id is NULL where CategoryName = ClaimAdmissionTypeCode then *Unknown Otherwise Name where CategoryName = ClaimAdmissionTypeCode |
CMS CJR Outpatient Claim Load
| AdmissionType |
*Not Applicable |
CMS CJR Part B Claim Load
| AdmissionType |
*Not Applicable |
CMS CJR Skilled Nursing Facility Claim Load
| AdmissionType |
|
||||||||
|
If TYPE_ADM is NULL then *Unspecified Otherwise if Id is NULL where CategoryName = ClaimAdmissionTypeCode then *Unknown Otherwise Name where CategoryName = ClaimAdmissionTypeCode |
Data Aggregation Medical Claim Load
| AdmissionType |
|
||||||
|
If AP_CLAIM.ADMISSION_TYPE_C is NULL then "*Unspecified" Otherwise if ZC_MC_ADM_TYPE.ADMISSION_TYPE_C is NULL then "*Unknown" Otherwise NAME |
Data Aggregation Pharmacy Claim Load
| AdmissionType |
"*Not Applicable" |
Externally Adjudicated Medical Claim Load
| AdmissionType |
|
||||||
|
If AP_CLAIM.ADMISSION_TYPE_C is NULL then "*Unspecified" Otherwise if ZC_MC_ADM_TYPE.ADMISSION_TYPE_C is NULL then "*Unknown" Otherwise NAME |
Externally Adjudicated Pharmacy Claim Load
| AdmissionType |
"*Not Applicable" |
Payer System Medical Claim Load
| AdmissionType |
|
||||||
|
If AP_CLAIM.ADMISSION_TYPE_C is NULL then "*Unspecified" Otherwise if ZC_MC_ADM_TYPE.ADMISSION_TYPE_C is NULL then "*Unknown" Otherwise NAME |
Payer System Pharmacy Claim Load
| AdmissionType |
"*Not Applicable" |
Received Claim Load
| AdmissionType |
|
||||||
|
If AP_CLAIM.ADMISSION_TYPE_C is NULL then "*Unspecified" Otherwise if ZC_MC_ADM_TYPE.ADMISSION_TYPE_C is NULL then "*Unknown" Otherwise NAME |
Received Pharmacy Claim Load
| AdmissionType |
"*Not Applicable" |
AdmissionSourceCode
: stringRecognized code for the source of the referral for the admission associated with the claim
Properties
- Data type
- string
- SQL Server data type
- nvarchar(50)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| AdmissionSourceCode |
|
||
CMS ACO Part B DME File Load
| AdmissionSourceCode |
"*Not Applicable" |
CMS ACO Part B Physicians File Load
| AdmissionSourceCode |
"*Not Applicable" |
CMS ACO Part D Prescription Drug File Load
| AdmissionSourceCode |
"*Not Applicable" |
CMS CJR DME Claim Load
| AdmissionSourceCode |
*Not Applicable |
CMS CJR Home Health Claim Load
| AdmissionSourceCode |
*Not Applicable |
CMS CJR Hospice Claim Load
| AdmissionSourceCode |
*Not Applicable |
CMS CJR Inpatient Claim Load
| AdmissionSourceCode |
|
||
CMS CJR Outpatient Claim Load
| AdmissionSourceCode |
*Not Applicable |
CMS CJR Part B Claim Load
| AdmissionSourceCode |
*Not Applicable |
CMS CJR Skilled Nursing Facility Claim Load
| AdmissionSourceCode |
|
||
Data Aggregation Medical Claim Load
| AdmissionSourceCode |
|
||||
|
If ADMSN_SRC is not NULL then ADMSN_SRC Otherwise ABBR |
Data Aggregation Pharmacy Claim Load
| AdmissionSourceCode |
"*Not Applicable" |
Externally Adjudicated Medical Claim Load
| AdmissionSourceCode |
|
||||
|
If ADMSN_SRC is not NULL then ADMSN_SRC Otherwise ABBR |
Externally Adjudicated Pharmacy Claim Load
| AdmissionSourceCode |
"*Not Applicable" |
Payer System Medical Claim Load
| AdmissionSourceCode |
|
||||
|
If ADMSN_SRC is not NULL then ADMSN_SRC Otherwise ABBR |
Payer System Pharmacy Claim Load
| AdmissionSourceCode |
"*Not Applicable" |
Received Claim Load
| AdmissionSourceCode |
|
||||
|
If ADMSN_SRC is not NULL then ADMSN_SRC Otherwise ABBR |
Received Pharmacy Claim Load
| AdmissionSourceCode |
"*Not Applicable" |
AdmissionSource
: stringSource of the referral for the admission associated with the claim
Properties
- Data type
- string
- SQL Server data type
- nvarchar(300)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| AdmissionSource |
|
||||||||||
|
If CLM_ADMSN_SRC_CD is NULL then "*Unspecified" Otherwise if Id is NULL where CLM_ADMSN_TYPE_CD = 4-Newborn and CategoryName = "ClaimAdmissionSourceCodeNewborn" then "*Unknown" Otherwise if Id is NULL where CategoryName = "ClaimAdmissionSourceCode" then "*Unknown" Otherwise if CLM_ADMSN_TYPE_CD = 4-Newborn then Name where CategoryName = "ClaimAdmissionSourceCodeNewborn" Otherwise Name where CategoryName = "ClaimAdmissionSourceCode" |
CMS ACO Part B DME File Load
| AdmissionSource |
"*Not Applicable" |
CMS ACO Part B Physicians File Load
| AdmissionSource |
"*Not Applicable" |
CMS ACO Part D Prescription Drug File Load
| AdmissionSource |
"*Not Applicable" |
CMS CJR DME Claim Load
| AdmissionSource |
*Not Applicable |
CMS CJR Home Health Claim Load
| AdmissionSource |
*Not Applicable |
CMS CJR Hospice Claim Load
| AdmissionSource |
*Not Applicable |
CMS CJR Inpatient Claim Load
| AdmissionSource |
|
||||||||||
|
If SRC_ADMS is NULL then *Unspecified Otherwise if Id is NULL where TYPE_ADM = 4-Newborn and CategoryName = ClaimAdmissionSourceCodeNewborn then *Unknown Otherwise if Id is NULL where CategoryName = ClaimAdmissionSourceCode then *Unknown Otherwise if TYPE_ADM = 4-Newborn then Name where CategoryName = ClaimAdmissionSourceCodeNewborn Otherwise Name where CategoryName = ClaimAdmissionSourceCode |
CMS CJR Outpatient Claim Load
| AdmissionSource |
*Not Applicable |
CMS CJR Part B Claim Load
| AdmissionSource |
*Not Applicable |
CMS CJR Skilled Nursing Facility Claim Load
| AdmissionSource |
|
||||||||||
|
If SRC_ADMS is NULL then *Unspecified Otherwise if Id is NULL where TYPE_ADM = 4-Newborn and CategoryName = ClaimAdmissionSourceCodeNewborn then *Unknown Otherwise if Id is NULL where CategoryName = ClaimAdmissionSourceCode then *Unknown Otherwise if TYPE_ADM = 4-Newborn then Name where CategoryName = ClaimAdmissionSourceCodeNewborn Otherwise Name where CategoryName = ClaimAdmissionSourceCode |
Data Aggregation Medical Claim Load
| AdmissionSource |
|
||||||
|
If AP_CLAIM.ADMISSION_SOURCE_C is NULL then "*Unspecified" Otherwise if ZC_MC_ADM_SOURCE.ADMISSION_SOURCE_C is NULL then "*Unknown" Otherwise NAME |
Data Aggregation Pharmacy Claim Load
| AdmissionSource |
"*Not Applicable" |
Externally Adjudicated Medical Claim Load
| AdmissionSource |
|
||||||
|
If AP_CLAIM.ADMISSION_SOURCE_C is NULL then "*Unspecified" Otherwise if ZC_MC_ADM_SOURCE.ADMISSION_SOURCE_C is NULL then "*Unknown" Otherwise NAME |
Externally Adjudicated Pharmacy Claim Load
| AdmissionSource |
"*Not Applicable" |
Payer System Medical Claim Load
| AdmissionSource |
|
||||||
|
If AP_CLAIM.ADMISSION_SOURCE_C is NULL then "*Unspecified" Otherwise if ZC_MC_ADM_SOURCE.ADMISSION_SOURCE_C is NULL then "*Unknown" Otherwise NAME |
Payer System Pharmacy Claim Load
| AdmissionSource |
"*Not Applicable" |
Received Claim Load
| AdmissionSource |
|
||||||
|
If AP_CLAIM.ADMISSION_SOURCE_C is NULL then "*Unspecified" Otherwise if ZC_MC_ADM_SOURCE.ADMISSION_SOURCE_C is NULL then "*Unknown" Otherwise NAME |
Received Pharmacy Claim Load
| AdmissionSource |
"*Not Applicable" |
DrgType
: stringClaim Diagnosis Related Diagnosis (DRG) type
Properties
- Data type
- string
- SQL Server data type
- nvarchar(300)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| DrgType |
This column isn't configured for use in reports. See an administrator for more information |
CMS ACO Part B DME File Load
| DrgType |
"*Not Applicable" |
CMS ACO Part B Physicians File Load
| DrgType |
"*Not Applicable" |
CMS ACO Part D Prescription Drug File Load
| DrgType |
"*Not Applicable" |
CMS CJR DME Claim Load
| DrgType |
*Not Applicable |
CMS CJR Home Health Claim Load
| DrgType |
*Not Applicable |
CMS CJR Hospice Claim Load
| DrgType |
*Not Applicable |
CMS CJR Inpatient Claim Load
| DrgType |
This column isn't configured for use in reports. See an administrator for more information. |
CMS CJR Outpatient Claim Load
| DrgType |
*Not Applicable |
CMS CJR Part B Claim Load
| DrgType |
*Not Applicable |
CMS CJR Skilled Nursing Facility Claim Load
| DrgType |
This column isn't configured for use in reports. See an administrator for more information. |
Data Aggregation Medical Claim Load
| DrgType |
|
||||
|
If ID_TYPE_NAME is not NULL for DRG_ID_TYPE_ID then ID_TYPE_NAME Otherwise "*Unspecified" |
Data Aggregation Pharmacy Claim Load
| DrgType |
"*Not Applicable" |
Externally Adjudicated Medical Claim Load
| DrgType |
|
||||
|
If ID_TYPE_NAME is not NULL for DRG_ID_TYPE_ID then ID_TYPE_NAME Otherwise "*Unspecified" |
Externally Adjudicated Pharmacy Claim Load
| DrgType |
"*Not Applicable" |
Payer System Medical Claim Load
| DrgType |
|
||||
|
If ID_TYPE_NAME is not NULL for DRG_ID_TYPE_ID then ID_TYPE_NAME Otherwise "*Unspecified" |
Payer System Pharmacy Claim Load
| DrgType |
"*Not Applicable" |
Received Claim Load
| DrgType |
|
||||
|
If ID_TYPE_NAME is not NULL for DRG_ID_TYPE_ID then ID_TYPE_NAME Otherwise "*Unspecified" |
Received Pharmacy Claim Load
| DrgType |
"*Not Applicable" |
DrgCode
: stringClaim Diagnosis Related Diagnosis (DRG) code
Properties
- Data type
- string
- SQL Server data type
- nvarchar(300)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| DrgCode |
|
||
CMS ACO Part B DME File Load
| DrgCode |
"*Not Applicable" |
CMS ACO Part B Physicians File Load
| DrgCode |
"*Not Applicable" |
CMS ACO Part D Prescription Drug File Load
| DrgCode |
"*Not Applicable" |
CMS CJR DME Claim Load
| DrgCode |
*Not Applicable |
CMS CJR Home Health Claim Load
| DrgCode |
*Not Applicable |
CMS CJR Hospice Claim Load
| DrgCode |
*Not Applicable |
CMS CJR Inpatient Claim Load
| DrgCode |
|
||
CMS CJR Outpatient Claim Load
| DrgCode |
*Not Applicable |
CMS CJR Part B Claim Load
| DrgCode |
*Not Applicable |
CMS CJR Skilled Nursing Facility Claim Load
| DrgCode |
*Not Applicable |
Data Aggregation Medical Claim Load
| DrgCode |
|
||||||
|
If DRG_ID_TYPE_ID is not NULL then MPI_ID for DRG_ID_TYPE_ID Otherwise MPI_ID for DRG_ID |
Data Aggregation Pharmacy Claim Load
| DrgCode |
"*Not Applicable" |
Externally Adjudicated Medical Claim Load
| DrgCode |
|
||||||
|
If DRG_ID_TYPE_ID is not NULL then MPI_ID for DRG_ID_TYPE_ID Otherwise MPI_ID for DRG_ID |
Externally Adjudicated Pharmacy Claim Load
| DrgCode |
"*Not Applicable" |
Payer System Medical Claim Load
| DrgCode |
|
||||||
|
If DRG_ID_TYPE_ID is not NULL then MPI_ID for DRG_ID_TYPE_ID Otherwise MPI_ID for DRG_ID |
Payer System Pharmacy Claim Load
| DrgCode |
"*Not Applicable" |
Received Claim Load
| DrgCode |
|
||||||
|
If DRG_ID_TYPE_ID is not NULL then MPI_ID for DRG_ID_TYPE_ID Otherwise MPI_ID for DRG_ID |
Received Pharmacy Claim Load
| DrgCode |
"*Not Applicable" |
SeverityOfIllness
: stringThe Severity Of Illness (SOI) of Diagnosis Related Group (DRG) determined for this claim
Properties
- Data type
- string
- SQL Server data type
- nvarchar(50)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| SeverityOfIllness |
CMS ACO Part B DME File Load
| SeverityOfIllness |
CMS ACO Part B Physicians File Load
| SeverityOfIllness |
CMS ACO Part D Prescription Drug File Load
| SeverityOfIllness |
CMS CJR DME Claim Load
| SeverityOfIllness |
CMS CJR Home Health Claim Load
| SeverityOfIllness |
CMS CJR Hospice Claim Load
| SeverityOfIllness |
CMS CJR Inpatient Claim Load
| SeverityOfIllness |
CMS CJR Outpatient Claim Load
| SeverityOfIllness |
CMS CJR Part B Claim Load
| SeverityOfIllness |
CMS CJR Skilled Nursing Facility Claim Load
| SeverityOfIllness |
Data Aggregation Medical Claim Load
| SeverityOfIllness |
|
||
Data Aggregation Pharmacy Claim Load
| SeverityOfIllness |
Externally Adjudicated Medical Claim Load
| SeverityOfIllness |
Externally Adjudicated Pharmacy Claim Load
| SeverityOfIllness |
Received Claim Load
| SeverityOfIllness |
Received Pharmacy Claim Load
| SeverityOfIllness |
RiskOfMortality
: stringThe Risk Of Mortality (ROM) of Diagnosis Related Group (DRG) determined for this claim
Properties
- Data type
- string
- SQL Server data type
- nvarchar(50)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| RiskOfMortality |
CMS ACO Part B DME File Load
| RiskOfMortality |
CMS ACO Part B Physicians File Load
| RiskOfMortality |
CMS ACO Part D Prescription Drug File Load
| RiskOfMortality |
CMS CJR DME Claim Load
| RiskOfMortality |
CMS CJR Home Health Claim Load
| RiskOfMortality |
CMS CJR Hospice Claim Load
| RiskOfMortality |
CMS CJR Inpatient Claim Load
| RiskOfMortality |
CMS CJR Outpatient Claim Load
| RiskOfMortality |
CMS CJR Part B Claim Load
| RiskOfMortality |
CMS CJR Skilled Nursing Facility Claim Load
| RiskOfMortality |
Data Aggregation Medical Claim Load
| RiskOfMortality |
|
||
Data Aggregation Pharmacy Claim Load
| RiskOfMortality |
Externally Adjudicated Medical Claim Load
| RiskOfMortality |
Externally Adjudicated Pharmacy Claim Load
| RiskOfMortality |
Received Claim Load
| RiskOfMortality |
Received Pharmacy Claim Load
| RiskOfMortality |
DischargeDispositionCode
: stringRecognized code for the discharge disposition of the patient associated with the claim
Properties
- Data type
- string
- SQL Server data type
- nvarchar(50)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| DischargeDispositionCode |
|
||
CMS ACO Part B DME File Load
| DischargeDispositionCode |
"*Not Applicable" |
CMS ACO Part B Physicians File Load
| DischargeDispositionCode |
"*Not Applicable" |
CMS ACO Part D Prescription Drug File Load
| DischargeDispositionCode |
"*Not Applicable" |
CMS CJR DME Claim Load
| DischargeDispositionCode |
*Not Applicable |
CMS CJR Home Health Claim Load
| DischargeDispositionCode |
|
||
CMS CJR Hospice Claim Load
| DischargeDispositionCode |
|
||
CMS CJR Inpatient Claim Load
| DischargeDispositionCode |
|
||
CMS CJR Outpatient Claim Load
| DischargeDispositionCode |
|
||
CMS CJR Part B Claim Load
| DischargeDispositionCode |
*Not Applicable |
CMS CJR Skilled Nursing Facility Claim Load
| DischargeDispositionCode |
|
||
Data Aggregation Medical Claim Load
| DischargeDispositionCode |
|
||||
|
If DISCHRG_DISP is not NULL then DISCHRG_DISP Otherwise PAT_STATUS_C |
Data Aggregation Pharmacy Claim Load
| DischargeDispositionCode |
"*Not Applicable" |
Externally Adjudicated Medical Claim Load
| DischargeDispositionCode |
|
||||
|
If DISCHRG_DISP is not NULL then DISCHRG_DISP Otherwise PAT_STATUS_C |
Externally Adjudicated Pharmacy Claim Load
| DischargeDispositionCode |
"*Not Applicable" |
Payer System Medical Claim Load
| DischargeDispositionCode |
|
||||
|
If DISCHRG_DISP is not NULL then DISCHRG_DISP Otherwise PAT_STATUS_C |
Payer System Pharmacy Claim Load
| DischargeDispositionCode |
"*Not Applicable" |
Received Claim Load
| DischargeDispositionCode |
|
||||
|
If DISCHRG_DISP is not NULL then DISCHRG_DISP Otherwise PAT_STATUS_C |
Received Pharmacy Claim Load
| DischargeDispositionCode |
"*Not Applicable" |
DischargeDisposition
: stringPatient discharge disposition
Properties
- Data type
- string
- SQL Server data type
- nvarchar(300)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| DischargeDisposition |
|
||||||||
|
If BENE_PTNT_STUS_CD is NULL then "*Unspecified" Otherwise if Id is NULL where CategoryName = "BeneficiaryPatientStatusCode" then "*Unknown" Otherwise Name where CategoryName = "BeneficiaryPatientStatusCode" |
CMS ACO Part B DME File Load
| DischargeDisposition |
"*Not Applicable" |
CMS ACO Part B Physicians File Load
| DischargeDisposition |
"*Not Applicable" |
CMS ACO Part D Prescription Drug File Load
| DischargeDisposition |
"*Not Applicable" |
CMS CJR DME Claim Load
| DischargeDisposition |
*Not Applicable |
CMS CJR Home Health Claim Load
| DischargeDisposition |
|
||||||||
|
If STUS_CD is NULL then *Unspecified If Id is NULL where CategoryName = BeneficiaryPatientStatusCode then *Unknown Otherwise Name |
CMS CJR Hospice Claim Load
| DischargeDisposition |
|
||||||||
|
If STUS_CD is NULL then *Unspecified If Id is NULL where CategoryName = BeneficiaryPatientStatusCode then *Unknown Otherwise Name |
CMS CJR Inpatient Claim Load
| DischargeDisposition |
|
||||||||
|
If STUS_CD is NULL then *Unspecified Otherwise if Id is NULL where CategoryName = BeneficiaryPatientStatusCode then *Unknown Otherwise Name where CategoryName = BeneficiaryPatientStatusCode |
CMS CJR Outpatient Claim Load
| DischargeDisposition |
|
||||||||
|
If STUS_CD is NULL then *Unspecified Otherwise if Id is NULL where CategoryName = BeneficiaryPatientStatusCode then *Unknown Otherwise Name where CategoryName = BeneficiaryPatientStatusCode |
CMS CJR Part B Claim Load
| DischargeDisposition |
*Not Applicable |
CMS CJR Skilled Nursing Facility Claim Load
| DischargeDisposition |
|
||||||||
|
If STUS_CD is NULL then *Unspecified Otherwise if Id is NULL where CategoryName = BeneficiaryPatientStatusCode then *Unknown Otherwise Name where CategoryName = BeneficiaryPatientStatusCode |
Data Aggregation Medical Claim Load
| DischargeDisposition |
|
||||||
Data Aggregation Pharmacy Claim Load
| DischargeDisposition |
"*Not Applicable" |
Externally Adjudicated Medical Claim Load
| DischargeDisposition |
|
||||||
|
If AP_CLAIM.PAT_STATUS_C is NULL then "*Unspecified" Otherwise if ZC_MC_PAT_STATUS.PAT_STATUS_C is NULL then "*Unknown" Otherwise NAME |
Externally Adjudicated Pharmacy Claim Load
| DischargeDisposition |
"*Not Applicable" |
Payer System Medical Claim Load
| DischargeDisposition |
|
||||||
|
If AP_CLAIM.PAT_STATUS_C is NULL then "*Unspecified" Otherwise if ZC_MC_PAT_STATUS.PAT_STATUS_C is NULL then "*Unknown" Otherwise NAME |
Payer System Pharmacy Claim Load
| DischargeDisposition |
"*Not Applicable" |
Received Claim Load
| DischargeDisposition |
|
||||||
|
If AP_CLAIM.PAT_STATUS_C is NULL then "*Unspecified" Otherwise if ZC_MC_PAT_STATUS.PAT_STATUS_C is NULL then "*Unknown" Otherwise NAME |
Received Pharmacy Claim Load
| DischargeDisposition |
"*Not Applicable" |
DenialReason
: stringClaim denial reason
Properties
- Data type
- string
- SQL Server data type
- nvarchar(300)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| DenialReason |
|
||||||||||
|
If CLM_MDCR_NPMT_RSN_CD is NULL then "*Unspecified" Otherwise if Id is NULL where CategoryName = "ClaimMedicareNonPaymentReasonCode" then "*Unknown" Otherwise if IsDenial = 0 then "*Not Applicable" Otherwise Name where CategoryName = "ClaimMedicareNonPaymentReasonCode" |
CMS ACO Part B DME File Load
| DenialReason |
|
||||||||||
|
If CLM_CARR_PMT_DNL_CD is NULL then "*Unspecified" Otherwise if Id is NULL where CategoryName = "ClaimCarrierPaymentDenialCode" then "*Unknown" Otherwise if IsDenial = 0 then "*Not Applicable" Otherwise Name where CategoryName = "ClaimCarrierPaymentDenialCode" |
CMS ACO Part B Physicians File Load
| DenialReason |
|
||||||||||
|
If CLM_CARR_PMT_DNL_CD is NULL then "*Unspecified" Otherwise if Id is NULL where CategoryName = "ClaimCarrierPaymentDenialCode" then "*Unknown" Otherwise if IsDenial = 0 then "*Not Applicable" Otherwise Name where CategoryName = "ClaimCarrierPaymentDenialCode" |
CMS ACO Part D Prescription Drug File Load
| DenialReason |
"*Not Applicable" |
CMS CJR DME Claim Load
| DenialReason |
*Not Applicable |
CMS CJR Home Health Claim Load
| DenialReason |
*Not Applicable |
CMS CJR Hospice Claim Load
| DenialReason |
*Not Applicable |
CMS CJR Inpatient Claim Load
| DenialReason |
*Not Applicable |
CMS CJR Outpatient Claim Load
| DenialReason |
*Not Applicable |
CMS CJR Part B Claim Load
| DenialReason |
*Not Applicable |
CMS CJR Skilled Nursing Facility Claim Load
| DenialReason |
*Not Applicable |
Data Aggregation Medical Claim Load
| DenialReason |
|
||||
|
IF NON_PAYMENT_RSN_CD IS NOT NULL AND NON_PAYMENT_RSN_DESC IS NULL THEN "*Unknown" Otherwise IF CARRIER_PAYMENT_DNL_CD IS NOT NULL AND CARRIER PAYMENT_DNL_DESC IS NULL THEN "*Unknown" Otherwise IF NON_PAYMENT_RSN_DESC IS NOT NULL THEN NON_PAYMENT_RSN_DESC Otherwise IF PAYMENT_DNL_DESC IS NOT NULL THEN PAYMENT_DNL_DESC Otherwise IF STATUS_C = 3 THEN "Denied" Otherwise "*Not Applicable" |
Data Aggregation Pharmacy Claim Load
| DenialReason |
|
||
Externally Adjudicated Medical Claim Load
| DenialReason |
|
||||||||||
|
If STATUS_C = 3 - Denied then "Denied" Otherwise "*Not Applicable" |
Externally Adjudicated Pharmacy Claim Load
| DenialReason |
|
||
|
If CLM_STATUS_C = 3 then "Denied" Otherwise "*Not Applicable" |
Payer System Medical Claim Load
| DenialReason |
|
||||
|
IF NON_PAYMENT_RSN_CD IS NOT NULL AND NON_PAYMENT_RSN_DESC IS NULL THEN "*Unknown" Otherwise IF CARRIER_PAYMENT_DNL_CD IS NOT NULL AND CARRIER PAYMENT_DNL_DESC IS NULL THEN "*Unknown" Otherwise IF NON_PAYMENT_RSN_DESC IS NOT NULL THEN NON_PAYMENT_RSN_DESC Otherwise IF PAYMENT_DNL_DESC IS NOT NULL THEN PAYMENT_DNL_DESC Otherwise IF STATUS_C = 3 THEN "Denied" Otherwise "*Not Applicable" |
Payer System Pharmacy Claim Load
| DenialReason |
|
||
Received Claim Load
| DenialReason |
|
||
|
If STATUS_C = 3 - Denied then "Denied" Otherwise "*Not Applicable" |
Received Pharmacy Claim Load
| DenialReason |
|
||
|
If CLM_STATUS_C = 3 then "Denied" Otherwise "*Not Applicable" |
StartDateKey
: integerFirst date services were rendered to the patient associated with the claim
Properties
- Data type
- integer
- SQL Server data type
- bigint
- Allows null
- No
- Default value
- -1
- Delete value
- -3
Data Lineage for Each Package
CMS ACO Part A Files Load
| StartDate |
|
||
|
If CLM_FROM_DT < 1/1/1753 or CLM_FROM_DT = 12/31/9999 then NULL Otherwise CLM_FROM_DT |
CMS ACO Part B DME File Load
| StartDate |
|
||
|
If CLM_FROM_DT < 1/1/1753 or CLM_FROM_DT = 12/31/9999 then NULL Otherwise CLM_FROM_DT |
CMS ACO Part B Physicians File Load
| StartDate |
|
||
|
If CLM_FROM_DT < 1/1/1753 or CLM_FROM_DT = 12/31/9999 then NULL Otherwise CLM_FROM_DT |
CMS ACO Part D Prescription Drug File Load
| StartDate |
|
||
|
If CLM_LINE_FROM_DT < 1/1/1753 or CLM_LINE_FROM_DT = 12/31/9999 then NULL Otherwise CLM_LINE_FROM_DT |
CMS CJR DME Claim Load
| StartDate |
|
||
CMS CJR Home Health Claim Load
| StartDate |
|
||
CMS CJR Hospice Claim Load
| StartDate |
|
||
CMS CJR Inpatient Claim Load
| StartDate |
|
||
CMS CJR Outpatient Claim Load
| StartDate |
|
||
CMS CJR Part B Claim Load
| StartDate |
|
||
CMS CJR Skilled Nursing Facility Claim Load
| StartDate |
|
||
Data Aggregation Medical Claim Load
| StartDate |
|
||||
|
Minimum of STMT_COV_FROM_DATE - Time Zone: Unspecified and SERVICE_START_DATE - Time Zone: Unspecified |
Data Aggregation Pharmacy Claim Load
| StartDate |
|
||
Externally Adjudicated Medical Claim Load
| StartDate |
|
||||
|
Minimum of STMT_COV_FROM_DATE - Time Zone: Unspecified and SERVICE_START_DATE - Time Zone: Unspecified |
Externally Adjudicated Pharmacy Claim Load
| StartDate |
|
||
Payer System Medical Claim Load
| StartDate |
|
||||
|
Minimum of STMT_COV_FROM_DATE - Time Zone: Unspecified and SERVICE_START_DATE - Time Zone: Unspecified |
Payer System Pharmacy Claim Load
| StartDate |
|
||
Received Claim Load
| StartDate |
|
||||
|
Minimum of STMT_COV_FROM_DATE - Time Zone: Unspecified and SERVICE_START_DATE - Time Zone: Unspecified |
Received Pharmacy Claim Load
| StartDate |
|
||
FormType
: stringForm type of the claim. This is populated with one of the following: institutional, professional, pharmacy, oral, or vision.
Properties
- Data type
- string
- SQL Server data type
- nvarchar(50)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| FormType |
"institutional" |
CMS ACO Part B DME File Load
| FormType |
"professional" |
CMS ACO Part B Physicians File Load
| FormType |
"professional" |
CMS ACO Part D Prescription Drug File Load
| FormType |
"pharmacy" |
CMS CJR DME Claim Load
| FormType |
professional |
CMS CJR Home Health Claim Load
| FormType |
institutional |
CMS CJR Hospice Claim Load
| FormType |
institutional |
CMS CJR Inpatient Claim Load
| FormType |
institutional |
CMS CJR Outpatient Claim Load
| FormType |
professional |
CMS CJR Part B Claim Load
| FormType |
professional |
CMS CJR Skilled Nursing Facility Claim Load
| FormType |
institutional |
Data Aggregation Medical Claim Load
| FormType |
|
||
|
If CLAIM_FORMAT_C = 1 - CMS then "professional" Otherwise if CLAIM_FORMAT_C = 2 - UB then "institutional" Otherwise "*Unknown" |
Data Aggregation Pharmacy Claim Load
| FormType |
"pharmacy" |
Externally Adjudicated Medical Claim Load
| FormType |
|
||
|
If CLAIM_FORMAT_C = 1 - CMS then "professional" Otherwise if CLAIM_FORMAT_C = 2 - UB then "institutional" Otherwise "*Unknown" |
Externally Adjudicated Pharmacy Claim Load
| FormType |
"pharmacy" |
Payer System Medical Claim Load
| FormType |
|
||
|
If CLAIM_FORMAT_C = 1 - CMS then "professional" Otherwise if CLAIM_FORMAT_C = 2 - UB then "institutional" Otherwise "*Unknown" |
Payer System Pharmacy Claim Load
| FormType |
"pharmacy" |
Received Claim Load
| FormType |
|
||
|
If CLAIM_FORMAT_C = 1 - CMS then "professional" Otherwise if CLAIM_FORMAT_C = 2 - UB then "institutional" Otherwise "*Unknown" |
Received Pharmacy Claim Load
| FormType |
"pharmacy" |
HospitalOutpatientServiceType
: stringType of hospital outpatient service associated with the claim
Properties
- Data type
- string
- SQL Server data type
- nvarchar(300)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| HospitalOutpatientServiceType |
|
||||||||
|
If CLM_OP_SRVC_TYPE_CD is NULL then "*Unspecified" Otherwise if Id is NULL where CategoryName = "ClaimOutpatientServiceTypeCode" then "*Unknown" Otherwise Name where CategoryName = "ClaimOutpatientServiceTypeCode" |
CMS ACO Part B DME File Load
| HospitalOutpatientServiceType |
"*Not Applicable" |
CMS ACO Part B Physicians File Load
| HospitalOutpatientServiceType |
"*Not Applicable" |
CMS ACO Part D Prescription Drug File Load
| HospitalOutpatientServiceType |
"*Not Applicable" |
CMS CJR DME Claim Load
| HospitalOutpatientServiceType |
*Not Applicable |
CMS CJR Home Health Claim Load
| HospitalOutpatientServiceType |
*Not Applicable |
CMS CJR Hospice Claim Load
| HospitalOutpatientServiceType |
*Not Applicable |
CMS CJR Inpatient Claim Load
| HospitalOutpatientServiceType |
*Not Applicable |
CMS CJR Outpatient Claim Load
| HospitalOutpatientServiceType |
*Not Applicable |
CMS CJR Part B Claim Load
| HospitalOutpatientServiceType |
*Not Applicable |
CMS CJR Skilled Nursing Facility Claim Load
| HospitalOutpatientServiceType |
*Not Applicable |
Data Aggregation Medical Claim Load
| HospitalOutpatientServiceType |
"*Not Applicable" |
Externally Adjudicated Medical Claim Load
| HospitalOutpatientServiceType |
"*Not Applicable" |
Payer System Medical Claim Load
| HospitalOutpatientServiceType |
"*Not Applicable" |
Received Claim Load
| HospitalOutpatientServiceType |
"*Not Applicable" |
InterpretedClaimType
: stringClaim type interpreted from form type, the type of bill codes, and the revenue codes
Properties
- Data type
- string
- SQL Server data type
- nvarchar(100)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| InterpretedClaimType |
NULL |
CMS ACO Part B DME File Load
| InterpretedClaimType |
NULL |
CMS ACO Part B Physicians File Load
| InterpretedClaimType |
NULL |
CMS ACO Part D Prescription Drug File Load
| InterpretedClaimType |
NULL |
CMS CJR DME Claim Load
| InterpretedClaimType |
NULL |
CMS CJR Home Health Claim Load
| InterpretedClaimType |
Home Health |
CMS CJR Hospice Claim Load
| InterpretedClaimType |
Hospice |
CMS CJR Inpatient Claim Load
| InterpretedClaimType |
|
||
|
If FAC_TYPE = 1-Hospital then Hospital Inpatient Otherwise Other Inpatient |
CMS CJR Outpatient Claim Load
| InterpretedClaimType |
NULL |
CMS CJR Part B Claim Load
| InterpretedClaimType |
NULL |
CMS CJR Skilled Nursing Facility Claim Load
| InterpretedClaimType |
Skilled Nursing Facility |
Data Aggregation Medical Claim Load
| InterpretedClaimType |
NULL |
Data Aggregation Pharmacy Claim Load
| InterpretedClaimType |
NULL |
Externally Adjudicated Medical Claim Load
| InterpretedClaimType |
NULL |
Externally Adjudicated Pharmacy Claim Load
| InterpretedClaimType |
NULL |
Payer System Medical Claim Load
| InterpretedClaimType |
NULL |
Payer System Pharmacy Claim Load
| InterpretedClaimType |
NULL |
Received Claim Load
| InterpretedClaimType |
NULL |
Received Pharmacy Claim Load
| InterpretedClaimType |
NULL |
ReceivedClaimType
: stringReceived claim type. For Epic data, this column can contain "Medical" for professional and institutional received claims and "Pharmacy" for pharmacy claims.
Properties
- Data type
- string
- SQL Server data type
- nvarchar(50)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| ReceivedClaimType |
|
||||||||
|
If CLM_TYPE_CD is NULL then "*Unspecified" Otherwise if Id is NULL where CategoryName = "ClaimTypeCode" then "*Unknown" Otherwise Name where CategoryName = "ClaimTypeCode" |
CMS ACO Part B DME File Load
| ReceivedClaimType |
|
||||||||
|
If CLM_TYPE_CD is NULL then "*Unspecified" Otherwise if Id is NULL where CategoryName = "ClaimTypeCode" then "*Unknown" Otherwise Name where CategoryName = "ClaimTypeCode" |
CMS ACO Part B Physicians File Load
| ReceivedClaimType |
|
||||||||
|
If CLM_TYPE_CD is NULL then "*Unspecified" Otherwise if Id is NULL where CategoryName = "ClaimTypeCode" then "*Unknown" Otherwise Name where CategoryName = "ClaimTypeCode" |
CMS ACO Part D Prescription Drug File Load
| ReceivedClaimType |
|
||||||||
|
If CLM_TYPE_CD is NULL then "*Unspecified" Otherwise if Id is NULL where CategoryName = "ClaimTypeCode" then "*Unknown" Otherwise Name where CategoryName = "ClaimTypeCode" |
CMS CJR DME Claim Load
| ReceivedClaimType |
|
||||||||
|
If CLM_TYPE_CD is NULL then *Unspecified Otherwise if Id is NULL where CategoryName = ClaimTypeCode then *Unknown Otherwise Name where CategoryName = ClaimTypeCode |
CMS CJR Home Health Claim Load
| ReceivedClaimType |
|
||||||||
|
If CLM_TYPE_CD is NULL then *Unspecified Otherwise if Id is NULL where CategoryName = ClaimTypeCode then *Unknown Otherwise Name where CategoryName = ClaimTypeCode |
CMS CJR Hospice Claim Load
| ReceivedClaimType |
|
||||||||
|
If CLM_TYPE_CD is NULL then *Unspecified Otherwise if Id is NULL where CategoryName = ClaimTypeCode then *Unknown Otherwise Name where CategoryName = ClaimTypeCode |
CMS CJR Inpatient Claim Load
| ReceivedClaimType |
|
||||||||
|
If CLM_TYPE_CD is NULL then *Unspecified Otherwise if Id is NULL where CategoryName = ClaimTypeCode then *Unknown Otherwise Name where CategoryName = ClaimTypeCode |
CMS CJR Outpatient Claim Load
| ReceivedClaimType |
|
||||||||
|
If CLM_TYPE_CD is NULL then *Unspecified Otherwise if Id is NULL where CategoryName = ClaimTypeCode then *Unknown Otherwise Name where CategoryName = ClaimTypeCode |
CMS CJR Part B Claim Load
| ReceivedClaimType |
|
||||||||
|
If CLM_TYPE_CD is NULL then *Unspecified Otherwise if Id is NULL where CategoryName = ClaimTypeCode then *Unknown Otherwise Name where CategoryName = ClaimTypeCode |
CMS CJR Skilled Nursing Facility Claim Load
| ReceivedClaimType |
|
||||||||
|
If CLM_TYPE_CD is NULL then *Unspecified Otherwise if Id is NULL where CategoryName = ClaimTypeCode then *Unknown Otherwise Name where CategoryName = ClaimTypeCode |
Data Aggregation Medical Claim Load
| ReceivedClaimType |
"Medical" |
Data Aggregation Pharmacy Claim Load
| ReceivedClaimType |
"Pharmacy" |
Externally Adjudicated Medical Claim Load
| ReceivedClaimType |
"Medical" |
Externally Adjudicated Pharmacy Claim Load
| ReceivedClaimType |
"Pharmacy" |
Payer System Medical Claim Load
| ReceivedClaimType |
"Medical" |
Payer System Pharmacy Claim Load
| ReceivedClaimType |
"Pharmacy" |
Received Claim Load
| ReceivedClaimType |
"Medical" |
Received Pharmacy Claim Load
| ReceivedClaimType |
"Pharmacy" |
TypeOfBillCode
: stringType of bill code
Properties
- Data type
- string
- SQL Server data type
- nvarchar(50)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| TypeOfBillCode |
|
||||||
|
Concatenation of CLM_BILL_FAC_TYPE_CD, CLM_BILL_CLSFCTN_CD, and CLM_BILL_FREQ_CD |
CMS ACO Part B DME File Load
| TypeOfBillCode |
"*Not Applicable" |
CMS ACO Part B Physicians File Load
| TypeOfBillCode |
"*Not Applicable" |
CMS ACO Part D Prescription Drug File Load
| TypeOfBillCode |
"*Not Applicable" |
CMS CJR DME Claim Load
| TypeOfBillCode |
*Not Applicable |
CMS CJR Home Health Claim Load
| TypeOfBillCode |
*Not Applicable |
CMS CJR Hospice Claim Load
| TypeOfBillCode |
*Not Applicable |
CMS CJR Inpatient Claim Load
| TypeOfBillCode |
*Not Applicable |
CMS CJR Outpatient Claim Load
| TypeOfBillCode |
*Not Applicable |
CMS CJR Part B Claim Load
| TypeOfBillCode |
*Not Applicable |
CMS CJR Skilled Nursing Facility Claim Load
| TypeOfBillCode |
*Not Applicable |
Data Aggregation Medical Claim Load
| TypeOfBillCode |
|
||
Data Aggregation Pharmacy Claim Load
| TypeOfBillCode |
"*Not Applicable" |
Externally Adjudicated Medical Claim Load
| TypeOfBillCode |
|
||
Externally Adjudicated Pharmacy Claim Load
| TypeOfBillCode |
"*Not Applicable" |
Payer System Medical Claim Load
| TypeOfBillCode |
|
||
Payer System Pharmacy Claim Load
| TypeOfBillCode |
"*Not Applicable" |
Received Claim Load
| TypeOfBillCode |
|
||
Received Pharmacy Claim Load
| TypeOfBillCode |
"*Not Applicable" |
FirstDiagnosisType
: stringType of the first diagnosis associated with the claim
Properties
- Data type
- string
- SQL Server data type
- nvarchar(50)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| FirstDiagnosisType |
|
||||
|
If DGNS_PRCDR_ICD_IND = 9-ICD 9 or FileGenerationDate < 2015-11-1 then "ICD-9-CM" Otherwise if DGNS_PRCDR_ICD_IND = 0-ICD 10 and FileGenerationDate >= 2015-11-1 then "ICD-10-CM" Otherwise "Unknown Code Type" |
CMS ACO Part B DME File Load
| FirstDiagnosisType |
"*Not Applicable" |
CMS ACO Part B Physicians File Load
| FirstDiagnosisType |
|
||||
|
If DGNS_PRCDR_ICD_IND = 9-ICD 9 or FileGenerationDate < 2015-11-1 then "ICD-9-CM" Otherwise if DGNS_PRCDR_ICD_IND = 0-ICD 10 and FileGenerationDate >= 2015-11-1 then "ICD-10-CM" Otherwise "Unknown Code Type" |
CMS ACO Part D Prescription Drug File Load
| FirstDiagnosisType |
"*Not Applicable" |
CMS CJR DME Claim Load
| FirstDiagnosisType |
|
||||
|
If CODE_VALUE is NULL then *Unspecified Otherwise if DGNS_PRCDR_ICD_IND = 9-ICD-9 or CLM_THRU_DT < 2015-10-01 then ICD-9-CM Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and CLM_THRU_DT >= 2015-10-01 then ICD-10-CM Otherwise *Unspecified |
CMS CJR Home Health Claim Load
| FirstDiagnosisType |
|
||||
|
If CODE_VALUE is NULL then *Unspecified Otherwise if DGNS_PRCDR_ICD_IND = 9-ICD-9 or CLM_THRU_DT < 2015-10-01 then ICD-9-CM Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and CLM_THRU_DT >= 2015-10-01 then ICD-10-CM Otherwise *Unspecified |
CMS CJR Hospice Claim Load
| FirstDiagnosisType |
|
||||
|
If CODE_VALUE is NULL then *Unspecified Otherwise if DGNS_PRCDR_ICD_IND = 9-ICD-9 or CLM_THRU_DT < 2015-10-01 then ICD-9-CM Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and CLM_THRU_DT >= 2015-10-01 then ICD-10-CM Otherwise *Unspecified |
CMS CJR Inpatient Claim Load
| FirstDiagnosisType |
|
||||||
|
If CODE_VALUE is NULL then *Unspecified Otherwise if DGNS_PRCDR_ICD_IND = 9-ICD-9 or DSCHRGDT < 2015-10-01 or ( DSCHRGDT is NULL and CLM_THRU_DT < 2015-10-01 ) then ICD-9-CM Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and ( DSCHRGDT >= 2015-10-01 or ( DSCHRGDT is NULL and CLM_THRU_DT >= 2015-10-01 ) ) then ICD-10-CM Otherwise *Unspecified |
CMS CJR Outpatient Claim Load
| FirstDiagnosisType |
|
||||
|
If CODE_VALUE is NULL then *Unspecified Otherwise if DGNS_PRCDR_ICD_IND = 9-ICD-9 or CLM_THRU_DT < 2015-10-01 then ICD-9-CM Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and CLM_THRU_DT >= 2015-10-01 then ICD-10-CM Otherwise *Unspecified |
CMS CJR Part B Claim Load
| FirstDiagnosisType |
|
||||
|
If CODE_VALUE is NULL then *Unspecified Otherwise if DGNS_PRCDR_ICD_IND = 9-ICD-9 or CLM_THRU_DT < 2015-10-01 then ICD-9-CM Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and CLM_THRU_DT >= 2015-10-01 then ICD-10-CM Otherwise *Unspecified |
CMS CJR Skilled Nursing Facility Claim Load
| FirstDiagnosisType |
|
||||||
|
If CODE_VALUE is NULL then *Unspecified Otherwise if DGNS_PRCDR_ICD_IND = 9-ICD-9 or DSCHRGDT < 2015-10-01 or ( DSCHRGDT is NULL and CLM_THRU_DT < 2015-10-01 ) then ICD-9-CM Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and ( DSCHRGDT >= 2015-10-01 or ( DSCHRGDT is NULL and CLM_THRU_DT >= 2015-10-01 ) ) then ICD-10-CM Otherwise *Unspecified |
Data Aggregation Medical Claim Load
| FirstDiagnosisType |
|
||||
Data Aggregation Pharmacy Claim Load
| FirstDiagnosisType |
|
||||
Externally Adjudicated Medical Claim Load
| FirstDiagnosisType |
|
||||||
|
If REF_BILL_CODE_SET_C = 1 or 2 where LINE = 1 then ZC_EDG_CODE_SET.NAME |
Externally Adjudicated Pharmacy Claim Load
| FirstDiagnosisType |
"*Not Applicable" |
Payer System Medical Claim Load
| FirstDiagnosisType |
|
||||
Payer System Pharmacy Claim Load
| FirstDiagnosisType |
|
||||
Received Claim Load
| FirstDiagnosisType |
|
||||||
|
If REF_BILL_CODE_SET_C = 1 or 2 where LINE = 1 then ZC_EDG_CODE_SET.NAME |
Received Pharmacy Claim Load
| FirstDiagnosisType |
"*Not Applicable" |
FirstDiagnosisCode
: stringCode of the first diagnosis associated with the claim
Properties
- Data type
- string
- SQL Server data type
- nvarchar(300)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| FirstDiagnosisCode |
|
||||
|
CLM_DGNS_CD where CLM_VAL_SQNC_NUM = 1 |
CMS ACO Part B DME File Load
| FirstDiagnosisCode |
"*Not Applicable" |
CMS ACO Part B Physicians File Load
| FirstDiagnosisCode |
|
||||||||||||||||||||||||||||
|
Unpivot CLM_DGNS_1_CD, CLM_DGNS_2_CD, CLM_DGNS_3_CD, CLM_DGNS_4_CD, CLM_DGNS_5_CD, CLM_DGNS_6_CD, CLM_DGNS_7_CD, CLM_DGNS_8_CD, CLM_DGNS_9_CD, CLM_DGNS_10_CD, CLM_DGNS_11_CD, CLM_DGNS_12_CD where row is numbered 1 by ( where DGNS_PRCDR_ICD_IND = 9-ICD 9 or DGNS_PRCDR_ICD_IND = 0-ICD 10 then 1 otherwise 2 ) then by minimum pivoted column name for each CUR_CLM_UNIQ_ID and CUR_CLM_UNIQ_ID is not NULL and unpivoted column is not NULL |
CMS ACO Part D Prescription Drug File Load
| FirstDiagnosisCode |
"*Not Applicable" |
CMS CJR DME Claim Load
| FirstDiagnosisCode |
If CODE_VALUE is not NULL then CODE_VALUE Otherwise *Unspecified |
CMS CJR Home Health Claim Load
| FirstDiagnosisCode |
If CODE_VALUE is not NULL then CODE_VALUE Otherwise *Unspecified |
CMS CJR Hospice Claim Load
| FirstDiagnosisCode |
If CODE_VALUE is not NULL then CODE_VALUE Otherwise *Unspecified |
CMS CJR Inpatient Claim Load
| FirstDiagnosisCode |
If CODE_VALUE is not NULL then CODE_VALUE Otherwise *Unspecified |
CMS CJR Outpatient Claim Load
| FirstDiagnosisCode |
If CODE_VALUE is not NULL then CODE_VALUE Otherwise *Unspecified |
CMS CJR Part B Claim Load
| FirstDiagnosisCode |
If CODE_VALUE is not NULL then CODE_VALUE Otherwise *Unspecified |
CMS CJR Skilled Nursing Facility Claim Load
| FirstDiagnosisCode |
If CODE_VALUE is not NULL then CODE_VALUE Otherwise *Unspecified |
Data Aggregation Medical Claim Load
| FirstDiagnosisCode |
|
||||
Data Aggregation Pharmacy Claim Load
| FirstDiagnosisCode |
|
||||
Externally Adjudicated Medical Claim Load
| FirstDiagnosisCode |
|
||||||
|
REF_BILL_CODE for DX_ID where AP_CLAIM_DX.LINE = 1 |
Externally Adjudicated Pharmacy Claim Load
| FirstDiagnosisCode |
"*Not Applicable" |
Payer System Medical Claim Load
| FirstDiagnosisCode |
|
||||
Payer System Pharmacy Claim Load
| FirstDiagnosisCode |
|
||||
Received Claim Load
| FirstDiagnosisCode |
|
||||||
|
REF_BILL_CODE for DX_ID where AP_CLAIM_DX.LINE = 1 |
Received Pharmacy Claim Load
| FirstDiagnosisCode |
"*Not Applicable" |
SecondDiagnosisType
: stringType of the second diagnosis associated with the claim
Properties
- Data type
- string
- SQL Server data type
- nvarchar(50)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| SecondDiagnosisType |
|
||||
|
If DGNS_PRCDR_ICD_IND = 9-ICD 9 or FileGenerationDate < 2015-11-1 then "ICD-9-CM" Otherwise if DGNS_PRCDR_ICD_IND = 0-ICD 10 and FileGenerationDate >= 2015-11-1 then "ICD-10-CM" Otherwise "Unknown Code Type" |
CMS ACO Part B DME File Load
| SecondDiagnosisType |
"*Not Applicable" |
CMS ACO Part B Physicians File Load
| SecondDiagnosisType |
|
||||
|
If DGNS_PRCDR_ICD_IND = 9-ICD 9 or FileGenerationDate < 2015-11-1 then "ICD-9-CM" Otherwise if DGNS_PRCDR_ICD_IND = 0-ICD 10 and FileGenerationDate >= 2015-11-1 then "ICD-10-CM Otherwise "Unknown Code Type" |
CMS ACO Part D Prescription Drug File Load
| SecondDiagnosisType |
"*Not Applicable" |
CMS CJR DME Claim Load
| SecondDiagnosisType |
|
||||
|
If CODE_VALUE is NULL then *Unspecified Otherwise if DGNS_PRCDR_ICD_IND = 9-ICD-9 or CLM_THRU_DT < 2015-10-01 then ICD-9-CM Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and CLM_THRU_DT >= 2015-10-01 then ICD-10-CM Otherwise *Unspecified |
CMS CJR Home Health Claim Load
| SecondDiagnosisType |
|
||||
|
If CODE_VALUE is NULL then *Unspecified Otherwise if DGNS_PRCDR_ICD_IND = 9-ICD-9 or CLM_THRU_DT < 2015-10-01 then ICD-9-CM Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and CLM_THRU_DT >= 2015-10-01 then ICD-10-CM Otherwise *Unspecified |
CMS CJR Hospice Claim Load
| SecondDiagnosisType |
|
||||
|
If CODE_VALUE is NULL then *Unspecified Otherwise if DGNS_PRCDR_ICD_IND = 9-ICD-9 or CLM_THRU_DT < 2015-10-01 then ICD-9-CM Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and CLM_THRU_DT >= 2015-10-01 then ICD-10-CM Otherwise *Unspecified |
CMS CJR Inpatient Claim Load
| SecondDiagnosisType |
|
||||||
|
If CODE_VALUE is NULL then *Unspecified Otherwise if DGNS_PRCDR_ICD_IND = 9-ICD-9 or DSCHRGDT < 2015-10-01 or ( DSCHRGDT is NULL and CLM_THRU_DT < 2015-10-01 ) then ICD-9-CM Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and ( DSCHRGDT >= 2015-10-01 or ( DSCHRGDT is NULL and CLM_THRU_DT >= 2015-10-01 ) ) then ICD-10-CM Otherwise *Unspecified |
CMS CJR Outpatient Claim Load
| SecondDiagnosisType |
|
||||
|
If CODE_VALUE is NULL then *Unspecified Otherwise if DGNS_PRCDR_ICD_IND = 9-ICD-9 or CLM_THRU_DT < 2015-10-01 then ICD-9-CM Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and CLM_THRU_DT >= 2015-10-01 then ICD-10-CM Otherwise *Unspecified |
CMS CJR Part B Claim Load
| SecondDiagnosisType |
|
||||
|
If CODE_VALUE is NULL then *Unspecified Otherwise if DGNS_PRCDR_ICD_IND = 9-ICD-9 or CLM_THRU_DT < 2015-10-01 then ICD-9-CM Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and CLM_THRU_DT >= 2015-10-01 then ICD-10-CM Otherwise *Unspecified |
CMS CJR Skilled Nursing Facility Claim Load
| SecondDiagnosisType |
|
||||||
|
If CODE_VALUE is NULL then *Unspecified Otherwise if DGNS_PRCDR_ICD_IND = 9-ICD-9 or DSCHRGDT < 2015-10-01 or ( DSCHRGDT is NULL and CLM_THRU_DT < 2015-10-01 ) then ICD-9-CM Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and ( DSCHRGDT >= 2015-10-01 or ( DSCHRGDT is NULL and CLM_THRU_DT >= 2015-10-01 ) ) then ICD-10-CM Otherwise *Unspecified |
Data Aggregation Medical Claim Load
| SecondDiagnosisType |
|
||||
Data Aggregation Pharmacy Claim Load
| SecondDiagnosisType |
|
||||
Externally Adjudicated Medical Claim Load
| SecondDiagnosisType |
|
||||||
|
If REF_BILL_CODE_SET_C = 1 or 2 where LINE = 2 then ZC_EDG_CODE_SET.NAME |
Externally Adjudicated Pharmacy Claim Load
| SecondDiagnosisType |
"*Not Applicable" |
Payer System Medical Claim Load
| SecondDiagnosisType |
|
||||
Payer System Pharmacy Claim Load
| SecondDiagnosisType |
|
||||
Received Claim Load
| SecondDiagnosisType |
|
||||||
|
If REF_BILL_CODE_SET_C = 1 or 2 where LINE = 2 then ZC_EDG_CODE_SET.NAME |
Received Pharmacy Claim Load
| SecondDiagnosisType |
"*Not Applicable" |
SecondDiagnosisCode
: stringCode of the second diagnosis associated with the claim
Properties
- Data type
- string
- SQL Server data type
- nvarchar(300)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| SecondDiagnosisCode |
|
||||
|
CLM_DGNS_CD where CLM_VAL_SQNC_NUM = 2 |
CMS ACO Part B DME File Load
| SecondDiagnosisCode |
"*Not Applicable" |
CMS ACO Part B Physicians File Load
| SecondDiagnosisCode |
|
||||||||||||||||||||||||||||
|
Unpivot CLM_DGNS_1_CD, CLM_DGNS_2_CD, CLM_DGNS_3_CD, CLM_DGNS_4_CD, CLM_DGNS_5_CD, CLM_DGNS_6_CD, CLM_DGNS_7_CD, CLM_DGNS_8_CD, CLM_DGNS_9_CD, CLM_DGNS_10_CD, CLM_DGNS_11_CD, CLM_DGNS_12_CD where row is numbered 2 by ( where DGNS_PRCDR_ICD_IND = 9-ICD 9 or DGNS_PRCDR_ICD_IND = 0-ICD 10 then 1 otherwise 2 ) then by minimum pivoted column name for each CUR_CLM_UNIQ_ID and CUR_CLM_UNIQ_ID is not NULL and unpivoted column is not NULL |
CMS ACO Part D Prescription Drug File Load
| SecondDiagnosisCode |
"*Not Applicable" |
CMS CJR DME Claim Load
| SecondDiagnosisCode |
If CODE_VALUE is not NULL then CODE_VALUE Otherwise *Unspecified |
CMS CJR Home Health Claim Load
| SecondDiagnosisCode |
If CODE_VALUE is not NULL then CODE_VALUE Otherwise *Unspecified |
CMS CJR Hospice Claim Load
| SecondDiagnosisCode |
If CODE_VALUE is not NULL then CODE_VALUE Otherwise *Unspecified |
CMS CJR Inpatient Claim Load
| SecondDiagnosisCode |
If CODE_VALUE is not NULL then CODE_VALUE Otherwise *Unspecified |
CMS CJR Outpatient Claim Load
| SecondDiagnosisCode |
If CODE_VALUE is not NULL then CODE_VALUE Otherwise *Unspecified |
CMS CJR Part B Claim Load
| SecondDiagnosisCode |
If CODE_VALUE is not NULL then CODE_VALUE Otherwise *Unspecified |
CMS CJR Skilled Nursing Facility Claim Load
| SecondDiagnosisCode |
If CODE_VALUE is not NULL then CODE_VALUE Otherwise *Unspecified |
Data Aggregation Medical Claim Load
| SecondDiagnosisCode |
|
||||
Data Aggregation Pharmacy Claim Load
| SecondDiagnosisCode |
|
||||
Externally Adjudicated Medical Claim Load
| SecondDiagnosisCode |
|
||||||
|
REF_BILL_CODE for DX_ID where AP_CLAIM_DX.LINE = 2 |
Externally Adjudicated Pharmacy Claim Load
| SecondDiagnosisCode |
"*Not Applicable" |
Payer System Medical Claim Load
| SecondDiagnosisCode |
|
||||
Payer System Pharmacy Claim Load
| SecondDiagnosisCode |
|
||||
Received Claim Load
| SecondDiagnosisCode |
|
||||||
|
REF_BILL_CODE for DX_ID where AP_CLAIM_DX.LINE = 2 |
Received Pharmacy Claim Load
| SecondDiagnosisCode |
"*Not Applicable" |
ThirdDiagnosisType
: stringType of the third diagnosis associated with the claim
Properties
- Data type
- string
- SQL Server data type
- nvarchar(50)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| ThirdDiagnosisType |
|
||||
|
If DGNS_PRCDR_ICD_IND = 9-ICD 9 or FileGenerationDate < 2015-11-1 then "ICD-9-CM" Otherwise if DGNS_PRCDR_ICD_IND = 0-ICD 10 and FileGenerationDate >= 2015-11-1 then "ICD-10-CM" Otherwise "Unknown Code Type" |
CMS ACO Part B DME File Load
| ThirdDiagnosisType |
"*Not Applicable" |
CMS ACO Part B Physicians File Load
| ThirdDiagnosisType |
|
||||
|
If DGNS_PRCDR_ICD_IND = 9-ICD 9 or FileGenerationDate < 2015-11-1 then "ICD-9-CM" Otherwise if DGNS_PRCDR_ICD_IND = 0-ICD 10 and FileGenerationDate >= 2015-11-1 then "ICD-10-CM Otherwise "Unknown Code Type" |
CMS ACO Part D Prescription Drug File Load
| ThirdDiagnosisType |
"*Not Applicable" |
CMS CJR DME Claim Load
| ThirdDiagnosisType |
|
||||
|
If CODE_VALUE is NULL then *Unspecified Otherwise if DGNS_PRCDR_ICD_IND = 9-ICD-9 or CLM_THRU_DT < 2015-10-01 then ICD-9-CM Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and CLM_THRU_DT >= 2015-10-01 then ICD-10-CM Otherwise *Unspecified |
CMS CJR Home Health Claim Load
| ThirdDiagnosisType |
|
||||
|
If CODE_VALUE is NULL then *Unspecified Otherwise if DGNS_PRCDR_ICD_IND = 9-ICD-9 or CLM_THRU_DT < 2015-10-01 then ICD-9-CM Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and CLM_THRU_DT >= 2015-10-01 then ICD-10-CM Otherwise *Unspecified |
CMS CJR Hospice Claim Load
| ThirdDiagnosisType |
|
||||
|
If CODE_VALUE is NULL then *Unspecified Otherwise if DGNS_PRCDR_ICD_IND = 9-ICD-9 or CLM_THRU_DT < 2015-10-01 then ICD-9-CM Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and CLM_THRU_DT >= 2015-10-01 then ICD-10-CM Otherwise *Unspecified |
CMS CJR Inpatient Claim Load
| ThirdDiagnosisType |
|
||||||
|
If CODE_VALUE is NULL then *Unspecified Otherwise if DGNS_PRCDR_ICD_IND = 9-ICD-9 or DSCHRGDT < 2015-10-01 or ( DSCHRGDT is NULL and CLM_THRU_DT < 2015-10-01 ) then ICD-9-CM Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and ( DSCHRGDT >= 2015-10-01 or ( DSCHRGDT is NULL and CLM_THRU_DT >= 2015-10-01 ) ) then ICD-10-CM Otherwise *Unspecified |
CMS CJR Outpatient Claim Load
| ThirdDiagnosisType |
|
||||
|
If CODE_VALUE is NULL then *Unspecified Otherwise if DGNS_PRCDR_ICD_IND = 9-ICD-9 or CLM_THRU_DT < 2015-10-01 then ICD-9-CM Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and CLM_THRU_DT >= 2015-10-01 then ICD-10-CM Otherwise *Unspecified |
CMS CJR Part B Claim Load
| ThirdDiagnosisType |
|
||||
|
If CODE_VALUE is NULL then *Unspecified Otherwise if DGNS_PRCDR_ICD_IND = 9-ICD-9 or CLM_THRU_DT < 2015-10-01 then ICD-9-CM Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and CLM_THRU_DT >= 2015-10-01 then ICD-10-CM Otherwise *Unspecified |
CMS CJR Skilled Nursing Facility Claim Load
| ThirdDiagnosisType |
|
||||||
|
If CODE_VALUE is NULL then *Unspecified Otherwise if DGNS_PRCDR_ICD_IND = 9-ICD-9 or DSCHRGDT < 2015-10-01 or ( DSCHRGDT is NULL and CLM_THRU_DT < 2015-10-01 ) then ICD-9-CM Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and ( DSCHRGDT >= 2015-10-01 or ( DSCHRGDT is NULL and CLM_THRU_DT >= 2015-10-01 ) ) then ICD-10-CM Otherwise *Unspecified |
Data Aggregation Medical Claim Load
| ThirdDiagnosisType |
|
||||
Data Aggregation Pharmacy Claim Load
| ThirdDiagnosisType |
|
||||
Externally Adjudicated Medical Claim Load
| ThirdDiagnosisType |
|
||||||
|
If REF_BILL_CODE_SET_C = 1 or 2 where LINE = 3 then ZC_EDG_CODE_SET.NAME |
Externally Adjudicated Pharmacy Claim Load
| ThirdDiagnosisType |
"*Not Applicable" |
Payer System Medical Claim Load
| ThirdDiagnosisType |
|
||||
Payer System Pharmacy Claim Load
| ThirdDiagnosisType |
|
||||
Received Claim Load
| ThirdDiagnosisType |
|
||||||
|
If REF_BILL_CODE_SET_C = 1 or 2 where LINE = 3 then ZC_EDG_CODE_SET.NAME |
Received Pharmacy Claim Load
| ThirdDiagnosisType |
"*Not Applicable" |
ThirdDiagnosisCode
: stringCode of the third diagnosis associated with the claim
Properties
- Data type
- string
- SQL Server data type
- nvarchar(300)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| ThirdDiagnosisCode |
|
||||
|
CLM_DGNS_CD where CLM_VAL_SQNC_NUM = 3 |
CMS ACO Part B DME File Load
| ThirdDiagnosisCode |
"*Not Applicable" |
CMS ACO Part B Physicians File Load
| ThirdDiagnosisCode |
|
||||||||||||||||||||||||||||
|
Unpivot CLM_DGNS_1_CD, CLM_DGNS_2_CD, CLM_DGNS_3_CD, CLM_DGNS_4_CD, CLM_DGNS_5_CD, CLM_DGNS_6_CD, CLM_DGNS_7_CD, CLM_DGNS_8_CD, CLM_DGNS_9_CD, CLM_DGNS_10_CD, CLM_DGNS_11_CD, CLM_DGNS_12_CD where row is numbered 3 by ( where DGNS_PRCDR_ICD_IND = 9-ICD 9 or DGNS_PRCDR_ICD_IND = 0-ICD 10 then 1 otherwise 2 ) then by minimum pivoted column name for each CUR_CLM_UNIQ_ID and CUR_CLM_UNIQ_ID is not NULL and unpivoted column is not NULL |
CMS ACO Part D Prescription Drug File Load
| ThirdDiagnosisCode |
"*Not Applicable" |
CMS CJR DME Claim Load
| ThirdDiagnosisCode |
If CODE_VALUE is not NULL then CODE_VALUE Otherwise *Unspecified |
CMS CJR Home Health Claim Load
| ThirdDiagnosisCode |
If CODE_VALUE is not NULL then CODE_VALUE Otherwise *Unspecified |
CMS CJR Hospice Claim Load
| ThirdDiagnosisCode |
If CODE_VALUE is not NULL then CODE_VALUE Otherwise *Unspecified |
CMS CJR Inpatient Claim Load
| ThirdDiagnosisCode |
If CODE_VALUE is not NULL then CODE_VALUE Otherwise *Unspecified |
CMS CJR Outpatient Claim Load
| ThirdDiagnosisCode |
If CODE_VALUE is not NULL then CODE_VALUE Otherwise *Unspecified |
CMS CJR Part B Claim Load
| ThirdDiagnosisCode |
If CODE_VALUE is not NULL then CODE_VALUE Otherwise *Unspecified |
CMS CJR Skilled Nursing Facility Claim Load
| ThirdDiagnosisCode |
If CODE_VALUE is not NULL then CODE_VALUE Otherwise *Unspecified |
Data Aggregation Medical Claim Load
| ThirdDiagnosisCode |
|
||||
Data Aggregation Pharmacy Claim Load
| ThirdDiagnosisCode |
|
||||
Externally Adjudicated Medical Claim Load
| ThirdDiagnosisCode |
|
||||||
|
REF_BILL_CODE for DX_ID where AP_CLAIM_DX.LINE = 3 |
Externally Adjudicated Pharmacy Claim Load
| ThirdDiagnosisCode |
"*Not Applicable" |
Payer System Medical Claim Load
| ThirdDiagnosisCode |
|
||||
Payer System Pharmacy Claim Load
| ThirdDiagnosisCode |
|
||||
Received Claim Load
| ThirdDiagnosisCode |
|
||||||
|
REF_BILL_CODE for DX_ID where AP_CLAIM_DX.LINE = 3 |
Received Pharmacy Claim Load
| ThirdDiagnosisCode |
"*Not Applicable" |
FourthDiagnosisType
: stringType of the fourth diagnosis associated with the claim
Properties
- Data type
- string
- SQL Server data type
- nvarchar(50)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| FourthDiagnosisType |
|
||||
|
If DGNS_PRCDR_ICD_IND = 9-ICD 9 or FileGenerationDate < 2015-11-1 then "ICD-9-CM" Otherwise if DGNS_PRCDR_ICD_IND = 0-ICD 10 and FileGenerationDate >= 2015-11-1 then "ICD-10-CM" Otherwise "Unknown Code Type" |
CMS ACO Part B DME File Load
| FourthDiagnosisType |
"*Not Applicable" |
CMS ACO Part B Physicians File Load
| FourthDiagnosisType |
|
||||
|
If DGNS_PRCDR_ICD_IND = 9-ICD 9 or FileGenerationDate < 2015-11-1 then "ICD-9-CM" Otherwise if DGNS_PRCDR_ICD_IND = 0-ICD 10 and FileGenerationDate >= 2015-11-1 then "ICD-10-CM Otherwise "Unknown Code Type" |
CMS ACO Part D Prescription Drug File Load
| FourthDiagnosisType |
"*Not Applicable" |
CMS CJR DME Claim Load
| FourthDiagnosisType |
|
||||
|
If CODE_VALUE is NULL then *Unspecified Otherwise if DGNS_PRCDR_ICD_IND = 9-ICD-9 or CLM_THRU_DT < 2015-10-01 then ICD-9-CM Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and CLM_THRU_DT >= 2015-10-01 then ICD-10-CM Otherwise *Unspecified |
CMS CJR Home Health Claim Load
| FourthDiagnosisType |
|
||||
|
If CODE_VALUE is NULL then *Unspecified Otherwise if DGNS_PRCDR_ICD_IND = 9-ICD-9 or CLM_THRU_DT < 2015-10-01 then ICD-9-CM Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and CLM_THRU_DT >= 2015-10-01 then ICD-10-CM Otherwise *Unspecified |
CMS CJR Hospice Claim Load
| FourthDiagnosisType |
|
||||
|
If CODE_VALUE is NULL then *Unspecified Otherwise if DGNS_PRCDR_ICD_IND = 9-ICD-9 or CLM_THRU_DT < 2015-10-01 then ICD-9-CM Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and CLM_THRU_DT >= 2015-10-01 then ICD-10-CM Otherwise *Unspecified |
CMS CJR Inpatient Claim Load
| FourthDiagnosisType |
|
||||||
|
If CODE_VALUE is NULL then *Unspecified Otherwise if DGNS_PRCDR_ICD_IND = 9-ICD-9 or DSCHRGDT < 2015-10-01 or ( DSCHRGDT is NULL and CLM_THRU_DT < 2015-10-01 ) then ICD-9-CM Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and ( DSCHRGDT >= 2015-10-01 or ( DSCHRGDT is NULL and CLM_THRU_DT >= 2015-10-01 ) ) then ICD-10-CM Otherwise *Unspecified |
CMS CJR Outpatient Claim Load
| FourthDiagnosisType |
|
||||
|
If CODE_VALUE is NULL then *Unspecified Otherwise if DGNS_PRCDR_ICD_IND = 9-ICD-9 or CLM_THRU_DT < 2015-10-01 then ICD-9-CM Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and CLM_THRU_DT >= 2015-10-01 then ICD-10-CM Otherwise *Unspecified |
CMS CJR Part B Claim Load
| FourthDiagnosisType |
|
||||
|
If CODE_VALUE is NULL then *Unspecified Otherwise if DGNS_PRCDR_ICD_IND = 9-ICD-9 or CLM_THRU_DT < 2015-10-01 then ICD-9-CM Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and CLM_THRU_DT >= 2015-10-01 then ICD-10-CM Otherwise *Unspecified |
CMS CJR Skilled Nursing Facility Claim Load
| FourthDiagnosisType |
|
||||||
|
If CODE_VALUE is NULL then *Unspecified Otherwise if DGNS_PRCDR_ICD_IND = 9-ICD-9 or DSCHRGDT < 2015-10-01 or ( DSCHRGDT is NULL and CLM_THRU_DT < 2015-10-01 ) then ICD-9-CM Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and ( DSCHRGDT >= 2015-10-01 or ( DSCHRGDT is NULL and CLM_THRU_DT >= 2015-10-01 ) ) then ICD-10-CM Otherwise *Unspecified |
Data Aggregation Medical Claim Load
| FourthDiagnosisType |
|
||||
Data Aggregation Pharmacy Claim Load
| FourthDiagnosisType |
|
||||
Externally Adjudicated Medical Claim Load
| FourthDiagnosisType |
|
||||||
|
If REF_BILL_CODE_SET_C = 1 or 2 where LINE = 4 then ZC_EDG_CODE_SET.NAME |
Externally Adjudicated Pharmacy Claim Load
| FourthDiagnosisType |
"*Not Applicable" |
Payer System Medical Claim Load
| FourthDiagnosisType |
|
||||
Payer System Pharmacy Claim Load
| FourthDiagnosisType |
|
||||
Received Claim Load
| FourthDiagnosisType |
|
||||||
|
If REF_BILL_CODE_SET_C = 1 or 2 where LINE = 4 then ZC_EDG_CODE_SET.NAME |
Received Pharmacy Claim Load
| FourthDiagnosisType |
"*Not Applicable" |
FourthDiagnosisCode
: stringCode of the fourth diagnosis associated with the claim
Properties
- Data type
- string
- SQL Server data type
- nvarchar(300)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| FourthDiagnosisCode |
|
||||
|
CLM_DGNS_CD where CLM_VAL_SQNC_NUM = 4 |
CMS ACO Part B DME File Load
| FourthDiagnosisCode |
"*Not Applicable" |
CMS ACO Part B Physicians File Load
| FourthDiagnosisCode |
|
||||||||||||||||||||||||||||
|
Unpivot CLM_DGNS_1_CD, CLM_DGNS_2_CD, CLM_DGNS_3_CD, CLM_DGNS_4_CD, CLM_DGNS_5_CD, CLM_DGNS_6_CD, CLM_DGNS_7_CD, CLM_DGNS_8_CD, CLM_DGNS_9_CD, CLM_DGNS_10_CD, CLM_DGNS_11_CD, CLM_DGNS_12_CD where row is numbered 4 by ( where DGNS_PRCDR_ICD_IND = 9 - ICD 9 or DGNS_PRCDR_ICD_IND = 0-ICD 10 then 1 otherwise 2 ) then by minimum pivoted column name for each CUR_CLM_UNIQ_ID and CUR_CLM_UNIQ_ID is not NULL and unpivoted column is not NULL |
CMS ACO Part D Prescription Drug File Load
| FourthDiagnosisCode |
"*Not Applicable" |
CMS CJR DME Claim Load
| FourthDiagnosisCode |
If CODE_VALUE is not NULL then CODE_VALUE Otherwise *Unspecified |
CMS CJR Home Health Claim Load
| FourthDiagnosisCode |
If CODE_VALUE is not NULL then CODE_VALUE Otherwise *Unspecified |
CMS CJR Hospice Claim Load
| FourthDiagnosisCode |
If CODE_VALUE is not NULL then CODE_VALUE Otherwise *Unspecified |
CMS CJR Inpatient Claim Load
| FourthDiagnosisCode |
If CODE_VALUE is not NULL then CODE_VALUE Otherwise *Unspecified |
CMS CJR Outpatient Claim Load
| FourthDiagnosisCode |
If CODE_VALUE is not NULL then CODE_VALUE Otherwise *Unspecified |
CMS CJR Part B Claim Load
| FourthDiagnosisCode |
If CODE_VALUE is not NULL then CODE_VALUE Otherwise *Unspecified |
CMS CJR Skilled Nursing Facility Claim Load
| FourthDiagnosisCode |
If CODE_VALUE is not NULL then CODE_VALUE Otherwise *Unspecified |
Data Aggregation Medical Claim Load
| FourthDiagnosisCode |
|
||||
Data Aggregation Pharmacy Claim Load
| FourthDiagnosisCode |
|
||||
Externally Adjudicated Medical Claim Load
| FourthDiagnosisCode |
|
||||||
|
REF_BILL_CODE for DX_ID where AP_CLAIM_DX.LINE = 4 |
Externally Adjudicated Pharmacy Claim Load
| FourthDiagnosisCode |
"*Not Applicable" |
Payer System Medical Claim Load
| FourthDiagnosisCode |
|
||||
Payer System Pharmacy Claim Load
| FourthDiagnosisCode |
|
||||
Received Claim Load
| FourthDiagnosisCode |
|
||||||
|
REF_BILL_CODE for DX_ID where AP_CLAIM_DX.LINE = 4 |
Received Pharmacy Claim Load
| FourthDiagnosisCode |
"*Not Applicable" |
FifthDiagnosisType
: stringType of the fifth diagnosis associated with the claim
Properties
- Data type
- string
- SQL Server data type
- nvarchar(50)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| FifthDiagnosisType |
|
||||
|
If DGNS_PRCDR_ICD_IND = 9-ICD 9 or FileGenerationDate < 2015-11-1 then "ICD-9-CM" Otherwise if DGNS_PRCDR_ICD_IND = 0-ICD 10 and FileGenerationDate >= 2015-11-1 then "ICD-10-CM" Otherwise "Unknown Code Type" |
CMS ACO Part B DME File Load
| FifthDiagnosisType |
"*Not Applicable" |
CMS ACO Part B Physicians File Load
| FifthDiagnosisType |
|
||||
|
If DGNS_PRCDR_ICD_IND = 9-ICD 9 or FileGenerationDate < 2015-11-1 then "ICD-9-CM" Otherwise if DGNS_PRCDR_ICD_IND = 0-ICD 10 and FileGenerationDate >= 2015-11-1 then "ICD-10-CM Otherwise "Unknown Code Type" |
CMS ACO Part D Prescription Drug File Load
| FifthDiagnosisType |
"*Not Applicable" |
CMS CJR DME Claim Load
| FifthDiagnosisType |
|
||||
|
If CODE_VALUE is NULL then *Unspecified Otherwise if DGNS_PRCDR_ICD_IND = 9-ICD-9 or CLM_THRU_DT < 2015-10-01 then ICD-9-CM Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and CLM_THRU_DT >= 2015-10-01 then ICD-10-CM Otherwise *Unspecified |
CMS CJR Home Health Claim Load
| FifthDiagnosisType |
|
||||
|
If CODE_VALUE is NULL then *Unspecified Otherwise if DGNS_PRCDR_ICD_IND = 9-ICD-9 or CLM_THRU_DT < 2015-10-01 then ICD-9-CM Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and CLM_THRU_DT >= 2015-10-01 then ICD-10-CM Otherwise *Unspecified |
CMS CJR Hospice Claim Load
| FifthDiagnosisType |
|
||||
|
If CODE_VALUE is NULL then *Unspecified Otherwise if DGNS_PRCDR_ICD_IND = 9-ICD-9 or CLM_THRU_DT < 2015-10-01 then ICD-9-CM Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and CLM_THRU_DT >= 2015-10-01 then ICD-10-CM Otherwise *Unspecified |
CMS CJR Inpatient Claim Load
| FifthDiagnosisType |
|
||||||
|
If CODE_VALUE is NULL then *Unspecified Otherwise if DGNS_PRCDR_ICD_IND = 9-ICD-9 or DSCHRGDT < 2015-10-01 or ( DSCHRGDT is NULL and CLM_THRU_DT < 2015-10-01 ) then ICD-9-CM Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and ( DSCHRGDT >= 2015-10-01 or ( DSCHRGDT is NULL and CLM_THRU_DT >= 2015-10-01 ) ) then ICD-10-CM Otherwise *Unspecified |
CMS CJR Outpatient Claim Load
| FifthDiagnosisType |
|
||||
|
If CODE_VALUE is NULL then *Unspecified Otherwise if DGNS_PRCDR_ICD_IND = 9-ICD-9 or CLM_THRU_DT < 2015-10-01 then ICD-9-CM Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and CLM_THRU_DT >= 2015-10-01 then ICD-10-CM Otherwise *Unspecified |
CMS CJR Part B Claim Load
| FifthDiagnosisType |
|
||||
|
If CODE_VALUE is NULL then *Unspecified Otherwise if DGNS_PRCDR_ICD_IND = 9-ICD-9 or CLM_THRU_DT < 2015-10-01 then ICD-9-CM Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and CLM_THRU_DT >= 2015-10-01 then ICD-10-CM Otherwise *Unspecified |
CMS CJR Skilled Nursing Facility Claim Load
| FifthDiagnosisType |
|
||||||
|
If CODE_VALUE is NULL then *Unspecified Otherwise if DGNS_PRCDR_ICD_IND = 9-ICD-9 or DSCHRGDT < 2015-10-01 or ( DSCHRGDT is NULL and CLM_THRU_DT < 2015-10-01 ) then ICD-9-CM Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and ( DSCHRGDT >= 2015-10-01 or ( DSCHRGDT is NULL and CLM_THRU_DT >= 2015-10-01 ) ) then ICD-10-CM Otherwise *Unspecified |
Data Aggregation Medical Claim Load
| FifthDiagnosisType |
|
||||
Data Aggregation Pharmacy Claim Load
| FifthDiagnosisType |
|
||||
Externally Adjudicated Medical Claim Load
| FifthDiagnosisType |
|
||||||
|
If REF_BILL_CODE_SET_C = 1 or 2 where LINE = 5 then ZC_EDG_CODE_SET.NAME |
Externally Adjudicated Pharmacy Claim Load
| FifthDiagnosisType |
"*Not Applicable" |
Payer System Medical Claim Load
| FifthDiagnosisType |
|
||||
Payer System Pharmacy Claim Load
| FifthDiagnosisType |
|
||||
Received Claim Load
| FifthDiagnosisType |
|
||||||
|
If REF_BILL_CODE_SET_C = 1 or 2 where LINE = 5 then ZC_EDG_CODE_SET.NAME |
Received Pharmacy Claim Load
| FifthDiagnosisType |
"*Not Applicable" |
FifthDiagnosisCode
: stringCode of the fifth diagnosis associated with the claim
Properties
- Data type
- string
- SQL Server data type
- nvarchar(300)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| FifthDiagnosisCode |
|
||||
|
CLM_DGNS_CD where CLM_VAL_SQNC_NUM = 5 |
CMS ACO Part B DME File Load
| FifthDiagnosisCode |
"*Not Applicable" |
CMS ACO Part B Physicians File Load
| FifthDiagnosisCode |
|
||||||||||||||||||||||||||||
|
Unpivot CLM_DGNS_1_CD, CLM_DGNS_2_CD, CLM_DGNS_3_CD, CLM_DGNS_4_CD, CLM_DGNS_5_CD, CLM_DGNS_6_CD, CLM_DGNS_7_CD, CLM_DGNS_8_CD, CLM_DGNS_9_CD, CLM_DGNS_10_CD, CLM_DGNS_11_CD, CLM_DGNS_12_CD where row is numbered 5 by ( where DGNS_PRCDR_ICD_IND = 9-ICD 9 or DGNS_PRCDR_ICD_IND = 0-ICD 10 then 1 otherwise 2 ) then by minimum pivoted column name for each CUR_CLM_UNIQ_ID and CUR_CLM_UNIQ_ID is not NULL and unpivoted column is not NULL |
CMS ACO Part D Prescription Drug File Load
| FifthDiagnosisCode |
"*Not Applicable" |
CMS CJR DME Claim Load
| FifthDiagnosisCode |
If CODE_VALUE is not NULL then CODE_VALUE Otherwise *Unspecified |
CMS CJR Home Health Claim Load
| FifthDiagnosisCode |
If CODE_VALUE is not NULL then CODE_VALUE Otherwise *Unspecified |
CMS CJR Hospice Claim Load
| FifthDiagnosisCode |
If CODE_VALUE is not NULL then CODE_VALUE Otherwise *Unspecified |
CMS CJR Inpatient Claim Load
| FifthDiagnosisCode |
If CODE_VALUE is not NULL then CODE_VALUE Otherwise *Unspecified |
CMS CJR Outpatient Claim Load
| FifthDiagnosisCode |
If CODE_VALUE is not NULL then CODE_VALUE Otherwise *Unspecified |
CMS CJR Part B Claim Load
| FifthDiagnosisCode |
If CODE_VALUE is not NULL then CODE_VALUE Otherwise *Unspecified |
CMS CJR Skilled Nursing Facility Claim Load
| FifthDiagnosisCode |
If CODE_VALUE is not NULL then CODE_VALUE Otherwise *Unspecified |
Data Aggregation Medical Claim Load
| FifthDiagnosisCode |
|
||||
Data Aggregation Pharmacy Claim Load
| FifthDiagnosisCode |
|
||||
Externally Adjudicated Medical Claim Load
| FifthDiagnosisCode |
|
||||||
|
REF_BILL_CODE for DX_ID where AP_CLAIM_DX.LINE = 5 |
Externally Adjudicated Pharmacy Claim Load
| FifthDiagnosisCode |
"*Not Applicable" |
Payer System Medical Claim Load
| FifthDiagnosisCode |
|
||||
Payer System Pharmacy Claim Load
| FifthDiagnosisCode |
|
||||
Received Claim Load
| FifthDiagnosisCode |
|
||||||
|
REF_BILL_CODE for DX_ID where AP_CLAIM_DX.LINE = 5 |
Received Pharmacy Claim Load
| FifthDiagnosisCode |
"*Not Applicable" |
SixthDiagnosisType
: stringType of the sixth diagnosis associated with the claim
Properties
- Data type
- string
- SQL Server data type
- nvarchar(50)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| SixthDiagnosisType |
|
||||
|
If DGNS_PRCDR_ICD_IND = 9-ICD 9 or FileGenerationDate < 2015-11-1 then "ICD-9-CM" Otherwise if DGNS_PRCDR_ICD_IND = 0-ICD 10 and FileGenerationDate >= 2015-11-1 then "ICD-10-CM" Otherwise "Unknown Code Type" |
CMS ACO Part B DME File Load
| SixthDiagnosisType |
"*Not Applicable" |
CMS ACO Part B Physicians File Load
| SixthDiagnosisType |
|
||||
|
If DGNS_PRCDR_ICD_IND = 9-ICD 9 or FileGenerationDate < 2015-11-1 then "ICD-9-CM" Otherwise if DGNS_PRCDR_ICD_IND = 0-ICD 10 and FileGenerationDate >= 2015-11-1 then "ICD-10-CM Otherwise "Unknown Code Type" |
CMS ACO Part D Prescription Drug File Load
| SixthDiagnosisType |
"*Not Applicable" |
CMS CJR DME Claim Load
| SixthDiagnosisType |
|
||||
|
If CODE_VALUE is NULL then *Unspecified Otherwise if DGNS_PRCDR_ICD_IND = 9-ICD-9 or CLM_THRU_DT < 2015-10-01 then ICD-9-CM Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and CLM_THRU_DT >= 2015-10-01 then ICD-10-CM Otherwise *Unspecified |
CMS CJR Home Health Claim Load
| SixthDiagnosisType |
|
||||
|
If CODE_VALUE is NULL then *Unspecified Otherwise if DGNS_PRCDR_ICD_IND = 9-ICD-9 or CLM_THRU_DT < 2015-10-01 then ICD-9-CM Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and CLM_THRU_DT >= 2015-10-01 then ICD-10-CM Otherwise *Unspecified |
CMS CJR Hospice Claim Load
| SixthDiagnosisType |
|
||||
|
If CODE_VALUE is NULL then *Unspecified Otherwise if DGNS_PRCDR_ICD_IND = 9-ICD-9 or CLM_THRU_DT < 2015-10-01 then ICD-9-CM Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and CLM_THRU_DT >= 2015-10-01 then ICD-10-CM Otherwise *Unspecified |
CMS CJR Inpatient Claim Load
| SixthDiagnosisType |
|
||||||
|
If CODE_VALUE is NULL then *Unspecified Otherwise if DGNS_PRCDR_ICD_IND = 9-ICD-9 or DSCHRGDT < 2015-10-01 or ( DSCHRGDT is NULL and CLM_THRU_DT < 2015-10-01 ) then ICD-9-CM Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and ( DSCHRGDT >= 2015-10-01 or ( DSCHRGDT is NULL and CLM_THRU_DT >= 2015-10-01 ) ) then ICD-10-CM Otherwise *Unspecified |
CMS CJR Outpatient Claim Load
| SixthDiagnosisType |
|
||||
|
If CODE_VALUE is NULL then *Unspecified Otherwise if DGNS_PRCDR_ICD_IND = 9-ICD-9 or CLM_THRU_DT < 2015-10-01 then ICD-9-CM Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and CLM_THRU_DT >= 2015-10-01 then ICD-10-CM Otherwise *Unspecified |
CMS CJR Part B Claim Load
| SixthDiagnosisType |
|
||||
|
If CODE_VALUE is NULL then *Unspecified Otherwise if DGNS_PRCDR_ICD_IND = 9-ICD-9 or CLM_THRU_DT < 2015-10-01 then ICD-9-CM Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and CLM_THRU_DT >= 2015-10-01 then ICD-10-CM Otherwise *Unspecified |
CMS CJR Skilled Nursing Facility Claim Load
| SixthDiagnosisType |
|
||||||
|
If CODE_VALUE is NULL then *Unspecified Otherwise if DGNS_PRCDR_ICD_IND = 9-ICD-9 or DSCHRGDT < 2015-10-01 or ( DSCHRGDT is NULL and CLM_THRU_DT < 2015-10-01 ) then ICD-9-CM Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and ( DSCHRGDT >= 2015-10-01 or ( DSCHRGDT is NULL and CLM_THRU_DT >= 2015-10-01 ) ) then ICD-10-CM Otherwise *Unspecified |
Data Aggregation Medical Claim Load
| SixthDiagnosisType |
|
||||
Data Aggregation Pharmacy Claim Load
| SixthDiagnosisType |
|
||||
Externally Adjudicated Medical Claim Load
| SixthDiagnosisType |
|
||||||
|
If REF_BILL_CODE_SET_C = 1 or 2 where LINE = 6 then ZC_EDG_CODE_SET.NAME |
Externally Adjudicated Pharmacy Claim Load
| SixthDiagnosisType |
"*Not Applicable" |
Payer System Medical Claim Load
| SixthDiagnosisType |
|
||||
Payer System Pharmacy Claim Load
| SixthDiagnosisType |
|
||||
Received Claim Load
| SixthDiagnosisType |
|
||||||
|
If REF_BILL_CODE_SET_C = 1 or 2 where LINE = 6 then ZC_EDG_CODE_SET.NAME |
Received Pharmacy Claim Load
| SixthDiagnosisType |
"*Not Applicable" |
SixthDiagnosisCode
: stringCode of the sixth diagnosis associated with the claim
Properties
- Data type
- string
- SQL Server data type
- nvarchar(300)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| SixthDiagnosisCode |
|
||||
|
CLM_DGNS_CD where CLM_VAL_SQNC_NUM = 6 |
CMS ACO Part B DME File Load
| SixthDiagnosisCode |
"*Not Applicable" |
CMS ACO Part B Physicians File Load
| SixthDiagnosisCode |
|
||||||||||||||||||||||||||||
|
Unpivot CLM_DGNS_1_CD, CLM_DGNS_2_CD, CLM_DGNS_3_CD, CLM_DGNS_4_CD, CLM_DGNS_5_CD, CLM_DGNS_6_CD, CLM_DGNS_7_CD, CLM_DGNS_8_CD, CLM_DGNS_9_CD, CLM_DGNS_10_CD, CLM_DGNS_11_CD, CLM_DGNS_12_CD where row is numbered 6 by ( where DGNS_PRCDR_ICD_IND = 9-ICD 9 or DGNS_PRCDR_ICD_IND = 0-ICD 10 then 1 otherwise 2 ) then by minimum pivoted column name for each CUR_CLM_UNIQ_ID and CUR_CLM_UNIQ_ID is not NULL and unpivoted column is not NULL |
CMS ACO Part D Prescription Drug File Load
| SixthDiagnosisCode |
"*Not Applicable" |
CMS CJR DME Claim Load
| SixthDiagnosisCode |
If CODE_VALUE is not NULL then CODE_VALUE Otherwise *Unspecified |
CMS CJR Home Health Claim Load
| SixthDiagnosisCode |
If CODE_VALUE is not NULL then CODE_VALUE Otherwise *Unspecified |
CMS CJR Hospice Claim Load
| SixthDiagnosisCode |
If CODE_VALUE is not NULL then CODE_VALUE Otherwise *Unspecified |
CMS CJR Inpatient Claim Load
| SixthDiagnosisCode |
If CODE_VALUE is not NULL then CODE_VALUE Otherwise *Unspecified |
CMS CJR Outpatient Claim Load
| SixthDiagnosisCode |
If CODE_VALUE is not NULL then CODE_VALUE Otherwise *Unspecified |
CMS CJR Part B Claim Load
| SixthDiagnosisCode |
If CODE_VALUE is not NULL then CODE_VALUE Otherwise *Unspecified |
CMS CJR Skilled Nursing Facility Claim Load
| SixthDiagnosisCode |
If CODE_VALUE is not NULL then CODE_VALUE Otherwise *Unspecified |
Data Aggregation Medical Claim Load
| SixthDiagnosisCode |
|
||||
Data Aggregation Pharmacy Claim Load
| SixthDiagnosisCode |
|
||||
Externally Adjudicated Medical Claim Load
| SixthDiagnosisCode |
|
||||||
|
REF_BILL_CODE for DX_ID where AP_CLAIM_DX.LINE = 6 |
Externally Adjudicated Pharmacy Claim Load
| SixthDiagnosisCode |
"*Not Applicable" |
Payer System Medical Claim Load
| SixthDiagnosisCode |
|
||||
Payer System Pharmacy Claim Load
| SixthDiagnosisCode |
|
||||
Received Claim Load
| SixthDiagnosisCode |
|
||||||
|
REF_BILL_CODE for DX_ID where AP_CLAIM_DX.LINE = 6 |
Received Pharmacy Claim Load
| SixthDiagnosisCode |
"*Not Applicable" |
BillingProviderSpecialty
: stringSpecialty of the provider under whose license number the claim was sent
Properties
- Data type
- string
- SQL Server data type
- nvarchar(300)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| BillingProviderSpecialty |
"*Not Applicable" |
CMS ACO Part B DME File Load
| BillingProviderSpecialty |
"*Not Applicable" |
CMS ACO Part B Physicians File Load
| BillingProviderSpecialty |
"*Not Applicable" |
CMS ACO Part D Prescription Drug File Load
| BillingProviderSpecialty |
"*Not Applicable" |
CMS CJR DME Claim Load
| BillingProviderSpecialty |
*Not Applicable |
CMS CJR Home Health Claim Load
| BillingProviderSpecialty |
*Not Applicable |
CMS CJR Hospice Claim Load
| BillingProviderSpecialty |
*Not Applicable |
CMS CJR Inpatient Claim Load
| BillingProviderSpecialty |
*Not Applicable |
CMS CJR Outpatient Claim Load
| BillingProviderSpecialty |
*Not Applicable |
CMS CJR Part B Claim Load
| BillingProviderSpecialty |
*Not Applicable |
CMS CJR Skilled Nursing Facility Claim Load
| BillingProviderSpecialty |
*Not Applicable |
Data Aggregation Medical Claim Load
| BillingProviderSpecialty |
|
||
Data Aggregation Pharmacy Claim Load
| BillingProviderSpecialty |
"*Not Applicable" |
Externally Adjudicated Pharmacy Claim Load
| BillingProviderSpecialty |
"*Not Applicable" |
Payer System Medical Claim Load
| BillingProviderSpecialty |
|
||
Payer System Pharmacy Claim Load
| BillingProviderSpecialty |
"*Not Applicable" |
Received Claim Load
| BillingProviderSpecialty |
|
||||||||||
Received Pharmacy Claim Load
| BillingProviderSpecialty |
"*Not Applicable" |
ReferringProviderSpecialty
: stringSpecialty of the provider who referred the patient to another provider. For Epic data, this column contains the referring provider's primary specialty as of the last time this claim was extracted from Clarity.
Properties
- Data type
- string
- SQL Server data type
- nvarchar(300)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| ReferringProviderSpecialty |
"*Not Applicable" |
CMS ACO Part B DME File Load
| ReferringProviderSpecialty |
"*Not Applicable" |
CMS ACO Part B Physicians File Load
| ReferringProviderSpecialty |
"*Not Applicable" |
CMS ACO Part D Prescription Drug File Load
| ReferringProviderSpecialty |
"*Not Applicable" |
CMS CJR DME Claim Load
| ReferringProviderSpecialty |
*Not Applicable |
CMS CJR Home Health Claim Load
| ReferringProviderSpecialty |
*Not Applicable |
CMS CJR Hospice Claim Load
| ReferringProviderSpecialty |
*Not Applicable |
CMS CJR Inpatient Claim Load
| ReferringProviderSpecialty |
*Not Applicable |
CMS CJR Outpatient Claim Load
| ReferringProviderSpecialty |
*Not Applicable |
CMS CJR Part B Claim Load
| ReferringProviderSpecialty |
*Not Applicable |
CMS CJR Skilled Nursing Facility Claim Load
| ReferringProviderSpecialty |
*Not Applicable |
Data Aggregation Pharmacy Claim Load
| ReferringProviderSpecialty |
"*Not Applicable" |
Externally Adjudicated Pharmacy Claim Load
| ReferringProviderSpecialty |
"*Not Applicable" |
Payer System Pharmacy Claim Load
| ReferringProviderSpecialty |
"*Not Applicable" |
Received Claim Load
| ReferringProviderSpecialty |
|
||||||||
|
If REF_PROV_TAXONOMY is not NULL then REF_PROV_TAXONOMY Otherwise if CLARITY_SER_SPEC.SPECIALTY_C is NULL then "*Unspecified" Otherwise if ZC_SPECIALTY.SPECIALTY_C is NULL then "*Unknown" Otherwise NAME |
Received Pharmacy Claim Load
| ReferringProviderSpecialty |
"*Not Applicable" |
RenderingProviderSpecialty
: stringSpecialty of the provider who rendered the care
Properties
- Data type
- string
- SQL Server data type
- nvarchar(300)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| RenderingProviderSpecialty |
"*Not Applicable" |
CMS ACO Part B DME File Load
| RenderingProviderSpecialty |
"*Not Applicable" |
CMS ACO Part B Physicians File Load
| RenderingProviderSpecialty |
"*Not Applicable" |
CMS ACO Part D Prescription Drug File Load
| RenderingProviderSpecialty |
"*Not Applicable" |
CMS CJR DME Claim Load
| RenderingProviderSpecialty |
*Not Applicable |
CMS CJR Home Health Claim Load
| RenderingProviderSpecialty |
*Not Applicable |
CMS CJR Hospice Claim Load
| RenderingProviderSpecialty |
*Not Applicable |
CMS CJR Inpatient Claim Load
| RenderingProviderSpecialty |
*Not Applicable |
CMS CJR Outpatient Claim Load
| RenderingProviderSpecialty |
*Not Applicable |
CMS CJR Part B Claim Load
| RenderingProviderSpecialty |
*Not Applicable |
CMS CJR Skilled Nursing Facility Claim Load
| RenderingProviderSpecialty |
*Not Applicable |
Data Aggregation Pharmacy Claim Load
| RenderingProviderSpecialty |
"*Not Applicable" |
Externally Adjudicated Pharmacy Claim Load
| RenderingProviderSpecialty |
"*Not Applicable" |
Payer System Pharmacy Claim Load
| RenderingProviderSpecialty |
"*Not Applicable" |
Received Claim Load
| RenderingProviderSpecialty |
|
||||||||||||||||||
|
If REND_PROV_NPI is not NULL then REND_PROV_TAXONOMY Otherwise if RENDERING_PROV_ID is not NULL then NULL Otherwise if CLAIM_FORMAT = 1 and DENTAL_INFO_YN = "Y" and ASST_SURG_NPI is not NULL then ASST_SURG_TAXONOMY Otherwise if CLAIM_FORMAT = 1 and BIL_PROV_NPI is not NULL then BIL_PROV_TAXONOMY |
Received Pharmacy Claim Load
| RenderingProviderSpecialty |
"*Not Applicable" |
AttendingProviderSpecialty
: stringSpecialty of the provider who managed the overall care of the admitted patient
Properties
- Data type
- string
- SQL Server data type
- nvarchar(300)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| AttendingProviderSpecialty |
"*Not Applicable" |
CMS ACO Part B DME File Load
| AttendingProviderSpecialty |
"*Not Applicable" |
CMS ACO Part B Physicians File Load
| AttendingProviderSpecialty |
"*Not Applicable" |
CMS ACO Part D Prescription Drug File Load
| AttendingProviderSpecialty |
"*Not Applicable" |
CMS CJR DME Claim Load
| AttendingProviderSpecialty |
*Not Applicable |
CMS CJR Home Health Claim Load
| AttendingProviderSpecialty |
*Not Applicable |
CMS CJR Hospice Claim Load
| AttendingProviderSpecialty |
*Not Applicable |
CMS CJR Inpatient Claim Load
| AttendingProviderSpecialty |
*Not Applicable |
CMS CJR Outpatient Claim Load
| AttendingProviderSpecialty |
*Not Applicable |
CMS CJR Part B Claim Load
| AttendingProviderSpecialty |
*Not Applicable |
CMS CJR Skilled Nursing Facility Claim Load
| AttendingProviderSpecialty |
*Not Applicable |
Data Aggregation Medical Claim Load
| AttendingProviderSpecialty |
|
||
Data Aggregation Pharmacy Claim Load
| AttendingProviderSpecialty |
"*Not Applicable" |
Externally Adjudicated Pharmacy Claim Load
| AttendingProviderSpecialty |
"*Not Applicable" |
Payer System Medical Claim Load
| AttendingProviderSpecialty |
|
||
Payer System Pharmacy Claim Load
| AttendingProviderSpecialty |
"*Not Applicable" |
Received Claim Load
| AttendingProviderSpecialty |
|
||
Received Pharmacy Claim Load
| AttendingProviderSpecialty |
"*Not Applicable" |
OperatingProviderSpecialty
: stringSpecialty of the provider who had the primary responsibility for performing the surgical procedure
Properties
- Data type
- string
- SQL Server data type
- nvarchar(300)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| OperatingProviderSpecialty |
"*Not Applicable" |
CMS ACO Part B DME File Load
| OperatingProviderSpecialty |
"*Not Applicable" |
CMS ACO Part B Physicians File Load
| OperatingProviderSpecialty |
"*Not Applicable" |
CMS ACO Part D Prescription Drug File Load
| OperatingProviderSpecialty |
"*Not Applicable" |
CMS CJR DME Claim Load
| OperatingProviderSpecialty |
*Not Applicable |
CMS CJR Home Health Claim Load
| OperatingProviderSpecialty |
*Not Applicable |
CMS CJR Hospice Claim Load
| OperatingProviderSpecialty |
*Not Applicable |
CMS CJR Inpatient Claim Load
| OperatingProviderSpecialty |
*Not Applicable |
CMS CJR Outpatient Claim Load
| OperatingProviderSpecialty |
*Not Applicable |
CMS CJR Part B Claim Load
| OperatingProviderSpecialty |
*Not Applicable |
CMS CJR Skilled Nursing Facility Claim Load
| OperatingProviderSpecialty |
*Not Applicable |
Data Aggregation Medical Claim Load
| OperatingProviderSpecialty |
"*Not Applicable" |
Data Aggregation Pharmacy Claim Load
| OperatingProviderSpecialty |
"*Not Applicable" |
Externally Adjudicated Medical Claim Load
| OperatingProviderSpecialty |
"*Not Applicable" |
Externally Adjudicated Pharmacy Claim Load
| OperatingProviderSpecialty |
"*Not Applicable" |
Payer System Medical Claim Load
| OperatingProviderSpecialty |
"*Not Applicable" |
Payer System Pharmacy Claim Load
| OperatingProviderSpecialty |
"*Not Applicable" |
Received Claim Load
| OperatingProviderSpecialty |
"*Not Applicable" |
Received Pharmacy Claim Load
| OperatingProviderSpecialty |
"*Not Applicable" |
OtherProviderSpecialty
: stringSpecialty of the other provider
Properties
- Data type
- string
- SQL Server data type
- nvarchar(300)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| OtherProviderSpecialty |
"*Not Applicable" |
CMS ACO Part B DME File Load
| OtherProviderSpecialty |
"*Not Applicable" |
CMS ACO Part B Physicians File Load
| OtherProviderSpecialty |
"*Not Applicable" |
CMS ACO Part D Prescription Drug File Load
| OtherProviderSpecialty |
"*Not Applicable" |
CMS CJR DME Claim Load
| OtherProviderSpecialty |
*Not Applicable |
CMS CJR Home Health Claim Load
| OtherProviderSpecialty |
*Not Applicable |
CMS CJR Hospice Claim Load
| OtherProviderSpecialty |
*Not Applicable |
CMS CJR Inpatient Claim Load
| OtherProviderSpecialty |
*Not Applicable |
CMS CJR Outpatient Claim Load
| OtherProviderSpecialty |
*Not Applicable |
CMS CJR Part B Claim Load
| OtherProviderSpecialty |
*Not Applicable |
CMS CJR Skilled Nursing Facility Claim Load
| OtherProviderSpecialty |
*Not Applicable |
Data Aggregation Medical Claim Load
| OtherProviderSpecialty |
"*Not Applicable" |
Data Aggregation Pharmacy Claim Load
| OtherProviderSpecialty |
"*Not Applicable" |
Externally Adjudicated Medical Claim Load
| OtherProviderSpecialty |
"*Not Applicable" |
Externally Adjudicated Pharmacy Claim Load
| OtherProviderSpecialty |
"*Not Applicable" |
Payer System Medical Claim Load
| OtherProviderSpecialty |
"*Not Applicable" |
Payer System Pharmacy Claim Load
| OtherProviderSpecialty |
"*Not Applicable" |
Received Claim Load
| OtherProviderSpecialty |
"*Not Applicable" |
Received Pharmacy Claim Load
| OtherProviderSpecialty |
"*Not Applicable" |
PrescribingProviderSpecialty
: stringSpecialty of the provider who prescribed the medication
Properties
- Data type
- string
- SQL Server data type
- nvarchar(300)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| PrescribingProviderSpecialty |
"*Not Applicable" |
CMS ACO Part B DME File Load
| PrescribingProviderSpecialty |
"*Not Applicable" |
CMS ACO Part B Physicians File Load
| PrescribingProviderSpecialty |
"*Not Applicable" |
CMS ACO Part D Prescription Drug File Load
| PrescribingProviderSpecialty |
"*Not Applicable" |
CMS CJR DME Claim Load
| PrescribingProviderSpecialty |
*Not Applicable |
CMS CJR Home Health Claim Load
| PrescribingProviderSpecialty |
*Not Applicable |
CMS CJR Hospice Claim Load
| PrescribingProviderSpecialty |
*Not Applicable |
CMS CJR Inpatient Claim Load
| PrescribingProviderSpecialty |
*Not Applicable |
CMS CJR Outpatient Claim Load
| PrescribingProviderSpecialty |
*Not Applicable |
CMS CJR Part B Claim Load
| PrescribingProviderSpecialty |
*Not Applicable |
CMS CJR Skilled Nursing Facility Claim Load
| PrescribingProviderSpecialty |
*Not Applicable |
Data Aggregation Medical Claim Load
| PrescribingProviderSpecialty |
"*Not Applicable" |
Data Aggregation Pharmacy Claim Load
| PrescribingProviderSpecialty |
"*Unspecified" |
Externally Adjudicated Medical Claim Load
| PrescribingProviderSpecialty |
"*Not Applicable" |
Externally Adjudicated Pharmacy Claim Load
| PrescribingProviderSpecialty |
|
||
Payer System Medical Claim Load
| PrescribingProviderSpecialty |
"*Not Applicable" |
Payer System Pharmacy Claim Load
| PrescribingProviderSpecialty |
"*Unspecified" |
Received Claim Load
| PrescribingProviderSpecialty |
"*Not Applicable" |
Received Pharmacy Claim Load
| PrescribingProviderSpecialty |
|
||
ServiceProviderSpecialty
: stringSpecialty of the provider who was responsible for the pharmacy service
Properties
- Data type
- string
- SQL Server data type
- nvarchar(300)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| ServiceProviderSpecialty |
"*Not Applicable" |
CMS ACO Part B DME File Load
| ServiceProviderSpecialty |
"*Not Applicable" |
CMS ACO Part B Physicians File Load
| ServiceProviderSpecialty |
"*Not Applicable" |
CMS ACO Part D Prescription Drug File Load
| ServiceProviderSpecialty |
"*Not Applicable" |
CMS CJR DME Claim Load
| ServiceProviderSpecialty |
*Not Applicable |
CMS CJR Home Health Claim Load
| ServiceProviderSpecialty |
*Not Applicable |
CMS CJR Hospice Claim Load
| ServiceProviderSpecialty |
*Not Applicable |
CMS CJR Inpatient Claim Load
| ServiceProviderSpecialty |
*Not Applicable |
CMS CJR Outpatient Claim Load
| ServiceProviderSpecialty |
*Not Applicable |
CMS CJR Part B Claim Load
| ServiceProviderSpecialty |
*Not Applicable |
CMS CJR Skilled Nursing Facility Claim Load
| ServiceProviderSpecialty |
*Not Applicable |
Data Aggregation Medical Claim Load
| ServiceProviderSpecialty |
*Not Applicable |
Data Aggregation Pharmacy Claim Load
| ServiceProviderSpecialty |
"*Unspecified" |
Externally Adjudicated Medical Claim Load
| ServiceProviderSpecialty |
*Not Applicable |
Externally Adjudicated Pharmacy Claim Load
| ServiceProviderSpecialty |
"*Unspecified" |
Payer System Medical Claim Load
| ServiceProviderSpecialty |
*Not Applicable |
Payer System Pharmacy Claim Load
| ServiceProviderSpecialty |
"*Unspecified" |
Received Claim Load
| ServiceProviderSpecialty |
*Not Applicable |
Received Pharmacy Claim Load
| ServiceProviderSpecialty |
"*Unspecified" |
BillingProviderCmsSpecialtyCode
: stringCenters for Medicare & Medicaid Services (CMS) code for the specialty of the provider under whose license number the claim was sent
Properties
- Data type
- string
- SQL Server data type
- nvarchar(50)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| BillingProviderCmsSpecialtyCode |
"*Not Applicable" |
CMS ACO Part B DME File Load
| BillingProviderCmsSpecialtyCode |
"*Not Applicable" |
CMS ACO Part B Physicians File Load
| BillingProviderCmsSpecialtyCode |
"*Not Applicable" |
CMS ACO Part D Prescription Drug File Load
| BillingProviderCmsSpecialtyCode |
"*Not Applicable" |
CMS CJR DME Claim Load
| BillingProviderCmsSpecialtyCode |
*Not Applicable |
CMS CJR Home Health Claim Load
| BillingProviderCmsSpecialtyCode |
*Not Applicable |
CMS CJR Hospice Claim Load
| BillingProviderCmsSpecialtyCode |
*Not Applicable |
CMS CJR Inpatient Claim Load
| BillingProviderCmsSpecialtyCode |
*Not Applicable |
CMS CJR Outpatient Claim Load
| BillingProviderCmsSpecialtyCode |
*Not Applicable |
CMS CJR Part B Claim Load
| BillingProviderCmsSpecialtyCode |
*Not Applicable |
CMS CJR Skilled Nursing Facility Claim Load
| BillingProviderCmsSpecialtyCode |
*Not Applicable |
Data Aggregation Medical Claim Load
| BillingProviderCmsSpecialtyCode |
NULL |
Data Aggregation Pharmacy Claim Load
| BillingProviderCmsSpecialtyCode |
"*Not Applicable" |
Externally Adjudicated Medical Claim Load
| BillingProviderCmsSpecialtyCode |
NULL |
Externally Adjudicated Pharmacy Claim Load
| BillingProviderCmsSpecialtyCode |
"*Not Applicable" |
Payer System Medical Claim Load
| BillingProviderCmsSpecialtyCode |
NULL |
Payer System Pharmacy Claim Load
| BillingProviderCmsSpecialtyCode |
"*Not Applicable" |
Received Claim Load
| BillingProviderCmsSpecialtyCode |
NULL |
Received Pharmacy Claim Load
| BillingProviderCmsSpecialtyCode |
"*Not Applicable" |
BillingProviderCmsSpecialtyName
: stringCenters for Medicare & Medicaid Services (CMS) name for the specialty of the provider under whose license number the claim was sent
Properties
- Data type
- string
- SQL Server data type
- nvarchar(300)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| BillingProviderCmsSpecialtyName |
"*Not Applicable" |
CMS ACO Part B DME File Load
| BillingProviderCmsSpecialtyName |
"*Not Applicable" |
CMS ACO Part B Physicians File Load
| BillingProviderCmsSpecialtyName |
"*Not Applicable" |
CMS ACO Part D Prescription Drug File Load
| BillingProviderCmsSpecialtyName |
"*Not Applicable" |
CMS CJR DME Claim Load
| BillingProviderCmsSpecialtyName |
*Not Applicable |
CMS CJR Home Health Claim Load
| BillingProviderCmsSpecialtyName |
*Not Applicable |
CMS CJR Hospice Claim Load
| BillingProviderCmsSpecialtyName |
*Not Applicable |
CMS CJR Inpatient Claim Load
| BillingProviderCmsSpecialtyName |
*Not Applicable |
CMS CJR Outpatient Claim Load
| BillingProviderCmsSpecialtyName |
*Not Applicable |
CMS CJR Part B Claim Load
| BillingProviderCmsSpecialtyName |
*Not Applicable |
CMS CJR Skilled Nursing Facility Claim Load
| BillingProviderCmsSpecialtyName |
*Not Applicable |
Data Aggregation Medical Claim Load
| BillingProviderCmsSpecialtyName |
NULL |
Data Aggregation Pharmacy Claim Load
| BillingProviderCmsSpecialtyName |
"*Not Applicable" |
Externally Adjudicated Medical Claim Load
| BillingProviderCmsSpecialtyName |
NULL |
Externally Adjudicated Pharmacy Claim Load
| BillingProviderCmsSpecialtyName |
"*Not Applicable" |
Payer System Medical Claim Load
| BillingProviderCmsSpecialtyName |
NULL |
Payer System Pharmacy Claim Load
| BillingProviderCmsSpecialtyName |
"*Not Applicable" |
Received Claim Load
| BillingProviderCmsSpecialtyName |
NULL |
Received Pharmacy Claim Load
| BillingProviderCmsSpecialtyName |
"*Not Applicable" |
ReferringProviderCmsSpecialtyCode
: stringCenters for Medicare & Medicaid Services (CMS) code for the specialty of the provider who referred the patient to another provider
Properties
- Data type
- string
- SQL Server data type
- nvarchar(50)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| ReferringProviderCmsSpecialtyCode |
"*Not Applicable" |
CMS ACO Part B DME File Load
| ReferringProviderCmsSpecialtyCode |
"*Not Applicable" |
CMS ACO Part B Physicians File Load
| ReferringProviderCmsSpecialtyCode |
"*Not Applicable" |
CMS ACO Part D Prescription Drug File Load
| ReferringProviderCmsSpecialtyCode |
"*Not Applicable" |
CMS CJR DME Claim Load
| ReferringProviderCmsSpecialtyCode |
*Not Applicable |
CMS CJR Home Health Claim Load
| ReferringProviderCmsSpecialtyCode |
*Not Applicable |
CMS CJR Hospice Claim Load
| ReferringProviderCmsSpecialtyCode |
*Not Applicable |
CMS CJR Inpatient Claim Load
| ReferringProviderCmsSpecialtyCode |
*Not Applicable |
CMS CJR Outpatient Claim Load
| ReferringProviderCmsSpecialtyCode |
*Not Applicable |
CMS CJR Part B Claim Load
| ReferringProviderCmsSpecialtyCode |
*Not Applicable |
CMS CJR Skilled Nursing Facility Claim Load
| ReferringProviderCmsSpecialtyCode |
*Not Applicable |
Data Aggregation Medical Claim Load
| ReferringProviderCmsSpecialtyCode |
NULL |
Data Aggregation Pharmacy Claim Load
| ReferringProviderCmsSpecialtyCode |
"*Not Applicable" |
Externally Adjudicated Medical Claim Load
| ReferringProviderCmsSpecialtyCode |
NULL |
Externally Adjudicated Pharmacy Claim Load
| ReferringProviderCmsSpecialtyCode |
"*Not Applicable" |
Payer System Medical Claim Load
| ReferringProviderCmsSpecialtyCode |
NULL |
Payer System Pharmacy Claim Load
| ReferringProviderCmsSpecialtyCode |
"*Not Applicable" |
Received Claim Load
| ReferringProviderCmsSpecialtyCode |
NULL |
Received Pharmacy Claim Load
| ReferringProviderCmsSpecialtyCode |
"*Not Applicable" |
ReferringProviderCmsSpecialtyName
: stringCenters for Medicare & Medicaid Services (CMS) name for the specialty of the provider who referred the patient to another provider
Properties
- Data type
- string
- SQL Server data type
- nvarchar(300)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| ReferringProviderCmsSpecialtyName |
"*Not Applicable" |
CMS ACO Part B DME File Load
| ReferringProviderCmsSpecialtyName |
"*Not Applicable" |
CMS ACO Part B Physicians File Load
| ReferringProviderCmsSpecialtyName |
"*Not Applicable" |
CMS ACO Part D Prescription Drug File Load
| ReferringProviderCmsSpecialtyName |
"*Not Applicable" |
CMS CJR DME Claim Load
| ReferringProviderCmsSpecialtyName |
*Not Applicable |
CMS CJR Home Health Claim Load
| ReferringProviderCmsSpecialtyName |
*Not Applicable |
CMS CJR Hospice Claim Load
| ReferringProviderCmsSpecialtyName |
*Not Applicable |
CMS CJR Inpatient Claim Load
| ReferringProviderCmsSpecialtyName |
*Not Applicable |
CMS CJR Outpatient Claim Load
| ReferringProviderCmsSpecialtyName |
*Not Applicable |
CMS CJR Part B Claim Load
| ReferringProviderCmsSpecialtyName |
*Not Applicable |
CMS CJR Skilled Nursing Facility Claim Load
| ReferringProviderCmsSpecialtyName |
*Not Applicable |
Data Aggregation Medical Claim Load
| ReferringProviderCmsSpecialtyName |
NULL |
Data Aggregation Pharmacy Claim Load
| ReferringProviderCmsSpecialtyName |
"*Not Applicable" |
Externally Adjudicated Medical Claim Load
| ReferringProviderCmsSpecialtyName |
NULL |
Externally Adjudicated Pharmacy Claim Load
| ReferringProviderCmsSpecialtyName |
"*Not Applicable" |
Payer System Medical Claim Load
| ReferringProviderCmsSpecialtyName |
NULL |
Payer System Pharmacy Claim Load
| ReferringProviderCmsSpecialtyName |
"*Not Applicable" |
Received Claim Load
| ReferringProviderCmsSpecialtyName |
NULL |
Received Pharmacy Claim Load
| ReferringProviderCmsSpecialtyName |
"*Not Applicable" |
RenderingProviderCmsSpecialtyCode
: stringCenters for Medicare & Medicaid Services (CMS) code for the specialty of the provider who rendered the care
Properties
- Data type
- string
- SQL Server data type
- nvarchar(50)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| RenderingProviderCmsSpecialtyCode |
"*Not Applicable" |
CMS ACO Part B DME File Load
| RenderingProviderCmsSpecialtyCode |
"*Not Applicable" |
CMS ACO Part B Physicians File Load
| RenderingProviderCmsSpecialtyCode |
"*Not Applicable" |
CMS ACO Part D Prescription Drug File Load
| RenderingProviderCmsSpecialtyCode |
"*Not Applicable" |
CMS CJR DME Claim Load
| RenderingProviderCmsSpecialtyCode |
*Not Applicable |
CMS CJR Home Health Claim Load
| RenderingProviderCmsSpecialtyCode |
*Not Applicable |
CMS CJR Hospice Claim Load
| RenderingProviderCmsSpecialtyCode |
*Not Applicable |
CMS CJR Inpatient Claim Load
| RenderingProviderCmsSpecialtyCode |
*Not Applicable |
CMS CJR Outpatient Claim Load
| RenderingProviderCmsSpecialtyCode |
*Not Applicable |
CMS CJR Part B Claim Load
| RenderingProviderCmsSpecialtyCode |
*Not Applicable |
CMS CJR Skilled Nursing Facility Claim Load
| RenderingProviderCmsSpecialtyCode |
*Not Applicable |
Data Aggregation Medical Claim Load
| RenderingProviderCmsSpecialtyCode |
NULL |
Data Aggregation Pharmacy Claim Load
| RenderingProviderCmsSpecialtyCode |
"*Not Applicable" |
Externally Adjudicated Medical Claim Load
| RenderingProviderCmsSpecialtyCode |
NULL |
Externally Adjudicated Pharmacy Claim Load
| RenderingProviderCmsSpecialtyCode |
"*Not Applicable" |
Payer System Medical Claim Load
| RenderingProviderCmsSpecialtyCode |
NULL |
Payer System Pharmacy Claim Load
| RenderingProviderCmsSpecialtyCode |
"*Not Applicable" |
Received Claim Load
| RenderingProviderCmsSpecialtyCode |
NULL |
Received Pharmacy Claim Load
| RenderingProviderCmsSpecialtyCode |
"*Not Applicable" |
RenderingProviderCmsSpecialtyName
: stringCenters for Medicare & Medicaid Services (CMS) name for the specialty of the provider who rendered the care
Properties
- Data type
- string
- SQL Server data type
- nvarchar(300)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| RenderingProviderCmsSpecialtyName |
"*Not Applicable" |
CMS ACO Part B DME File Load
| RenderingProviderCmsSpecialtyName |
"*Not Applicable" |
CMS ACO Part B Physicians File Load
| RenderingProviderCmsSpecialtyName |
"*Not Applicable" |
CMS ACO Part D Prescription Drug File Load
| RenderingProviderCmsSpecialtyName |
"*Not Applicable" |
CMS CJR DME Claim Load
| RenderingProviderCmsSpecialtyName |
*Not Applicable |
CMS CJR Home Health Claim Load
| RenderingProviderCmsSpecialtyName |
*Not Applicable |
CMS CJR Hospice Claim Load
| RenderingProviderCmsSpecialtyName |
*Not Applicable |
CMS CJR Inpatient Claim Load
| RenderingProviderCmsSpecialtyName |
*Not Applicable |
CMS CJR Outpatient Claim Load
| RenderingProviderCmsSpecialtyName |
*Not Applicable |
CMS CJR Part B Claim Load
| RenderingProviderCmsSpecialtyName |
*Not Applicable |
CMS CJR Skilled Nursing Facility Claim Load
| RenderingProviderCmsSpecialtyName |
*Not Applicable |
Data Aggregation Medical Claim Load
| RenderingProviderCmsSpecialtyName |
NULL |
Data Aggregation Pharmacy Claim Load
| RenderingProviderCmsSpecialtyName |
"*Not Applicable" |
Externally Adjudicated Medical Claim Load
| RenderingProviderCmsSpecialtyName |
NULL |
Externally Adjudicated Pharmacy Claim Load
| RenderingProviderCmsSpecialtyName |
"*Not Applicable" |
Payer System Medical Claim Load
| RenderingProviderCmsSpecialtyName |
NULL |
Payer System Pharmacy Claim Load
| RenderingProviderCmsSpecialtyName |
"*Not Applicable" |
Received Claim Load
| RenderingProviderCmsSpecialtyName |
NULL |
Received Pharmacy Claim Load
| RenderingProviderCmsSpecialtyName |
"*Not Applicable" |
AttendingProviderCmsSpecialtyCode
: stringCenters for Medicare & Medicaid Services (CMS) code for the specialty of the provider who managed the overall care of the admitted patient
Properties
- Data type
- string
- SQL Server data type
- nvarchar(50)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| AttendingProviderCmsSpecialtyCode |
"*Not Applicable" |
CMS ACO Part B DME File Load
| AttendingProviderCmsSpecialtyCode |
"*Not Applicable" |
CMS ACO Part B Physicians File Load
| AttendingProviderCmsSpecialtyCode |
"*Not Applicable" |
CMS ACO Part D Prescription Drug File Load
| AttendingProviderCmsSpecialtyCode |
"*Not Applicable" |
CMS CJR DME Claim Load
| AttendingProviderCmsSpecialtyCode |
*Not Applicable |
CMS CJR Home Health Claim Load
| AttendingProviderCmsSpecialtyCode |
*Not Applicable |
CMS CJR Hospice Claim Load
| AttendingProviderCmsSpecialtyCode |
*Not Applicable |
CMS CJR Inpatient Claim Load
| AttendingProviderCmsSpecialtyCode |
*Not Applicable |
CMS CJR Outpatient Claim Load
| AttendingProviderCmsSpecialtyCode |
*Not Applicable |
CMS CJR Part B Claim Load
| AttendingProviderCmsSpecialtyCode |
*Not Applicable |
CMS CJR Skilled Nursing Facility Claim Load
| AttendingProviderCmsSpecialtyCode |
*Not Applicable |
Data Aggregation Medical Claim Load
| AttendingProviderCmsSpecialtyCode |
NULL |
Data Aggregation Pharmacy Claim Load
| AttendingProviderCmsSpecialtyCode |
"*Not Applicable" |
Externally Adjudicated Medical Claim Load
| AttendingProviderCmsSpecialtyCode |
NULL |
Externally Adjudicated Pharmacy Claim Load
| AttendingProviderCmsSpecialtyCode |
"*Not Applicable" |
Payer System Medical Claim Load
| AttendingProviderCmsSpecialtyCode |
NULL |
Payer System Pharmacy Claim Load
| AttendingProviderCmsSpecialtyCode |
"*Not Applicable" |
Received Claim Load
| AttendingProviderCmsSpecialtyCode |
NULL |
Received Pharmacy Claim Load
| AttendingProviderCmsSpecialtyCode |
"*Not Applicable" |
AttendingProviderCmsSpecialtyName
: stringCenters for Medicare & Medicaid Services (CMS) name for the specialty of the provider who managed the overall care of the admitted patient
Properties
- Data type
- string
- SQL Server data type
- nvarchar(300)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| AttendingProviderCmsSpecialtyName |
"*Not Applicable" |
CMS ACO Part B DME File Load
| AttendingProviderCmsSpecialtyName |
"*Not Applicable" |
CMS ACO Part B Physicians File Load
| AttendingProviderCmsSpecialtyName |
"*Not Applicable" |
CMS ACO Part D Prescription Drug File Load
| AttendingProviderCmsSpecialtyName |
"*Not Applicable" |
CMS CJR DME Claim Load
| AttendingProviderCmsSpecialtyName |
*Not Applicable |
CMS CJR Home Health Claim Load
| AttendingProviderCmsSpecialtyName |
*Not Applicable |
CMS CJR Hospice Claim Load
| AttendingProviderCmsSpecialtyName |
*Not Applicable |
CMS CJR Inpatient Claim Load
| AttendingProviderCmsSpecialtyName |
*Not Applicable |
CMS CJR Outpatient Claim Load
| AttendingProviderCmsSpecialtyName |
*Not Applicable |
CMS CJR Part B Claim Load
| AttendingProviderCmsSpecialtyName |
*Not Applicable |
CMS CJR Skilled Nursing Facility Claim Load
| AttendingProviderCmsSpecialtyName |
*Not Applicable |
Data Aggregation Medical Claim Load
| AttendingProviderCmsSpecialtyName |
NULL |
Data Aggregation Pharmacy Claim Load
| AttendingProviderCmsSpecialtyName |
"*Not Applicable" |
Externally Adjudicated Medical Claim Load
| AttendingProviderCmsSpecialtyName |
NULL |
Externally Adjudicated Pharmacy Claim Load
| AttendingProviderCmsSpecialtyName |
"*Not Applicable" |
Payer System Medical Claim Load
| AttendingProviderCmsSpecialtyName |
NULL |
Payer System Pharmacy Claim Load
| AttendingProviderCmsSpecialtyName |
"*Not Applicable" |
Received Claim Load
| AttendingProviderCmsSpecialtyName |
NULL |
Received Pharmacy Claim Load
| AttendingProviderCmsSpecialtyName |
"*Not Applicable" |
OperatingProviderCmsSpecialtyCode
: stringCenters for Medicare & Medicaid Services (CMS) code for the specialty of the provider who had the primary responsibility for performing the surgical procedure
Properties
- Data type
- string
- SQL Server data type
- nvarchar(50)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| OperatingProviderCmsSpecialtyCode |
"*Not Applicable" |
CMS ACO Part B DME File Load
| OperatingProviderCmsSpecialtyCode |
"*Not Applicable" |
CMS ACO Part B Physicians File Load
| OperatingProviderCmsSpecialtyCode |
"*Not Applicable" |
CMS ACO Part D Prescription Drug File Load
| OperatingProviderCmsSpecialtyCode |
"*Not Applicable" |
CMS CJR DME Claim Load
| OperatingProviderCmsSpecialtyCode |
*Not Applicable |
CMS CJR Home Health Claim Load
| OperatingProviderCmsSpecialtyCode |
*Not Applicable |
CMS CJR Hospice Claim Load
| OperatingProviderCmsSpecialtyCode |
*Not Applicable |
CMS CJR Inpatient Claim Load
| OperatingProviderCmsSpecialtyCode |
*Not Applicable |
CMS CJR Outpatient Claim Load
| OperatingProviderCmsSpecialtyCode |
*Not Applicable |
CMS CJR Part B Claim Load
| OperatingProviderCmsSpecialtyCode |
*Not Applicable |
CMS CJR Skilled Nursing Facility Claim Load
| OperatingProviderCmsSpecialtyCode |
*Not Applicable |
Data Aggregation Medical Claim Load
| OperatingProviderCmsSpecialtyCode |
NULL |
Data Aggregation Pharmacy Claim Load
| OperatingProviderCmsSpecialtyCode |
"*Not Applicable" |
Externally Adjudicated Medical Claim Load
| OperatingProviderCmsSpecialtyCode |
NULL |
Externally Adjudicated Pharmacy Claim Load
| OperatingProviderCmsSpecialtyCode |
"*Not Applicable" |
Payer System Medical Claim Load
| OperatingProviderCmsSpecialtyCode |
NULL |
Payer System Pharmacy Claim Load
| OperatingProviderCmsSpecialtyCode |
"*Not Applicable" |
Received Claim Load
| OperatingProviderCmsSpecialtyCode |
NULL |
Received Pharmacy Claim Load
| OperatingProviderCmsSpecialtyCode |
"*Not Applicable" |
OperatingProviderCmsSpecialtyName
: stringCenters for Medicare & Medicaid Services (CMS) name for the specialty of the provider who had the primary responsibility for performing the surgical procedure
Properties
- Data type
- string
- SQL Server data type
- nvarchar(300)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| OperatingProviderCmsSpecialtyName |
"*Not Applicable" |
CMS ACO Part B DME File Load
| OperatingProviderCmsSpecialtyName |
"*Not Applicable" |
CMS ACO Part B Physicians File Load
| OperatingProviderCmsSpecialtyName |
"*Not Applicable" |
CMS ACO Part D Prescription Drug File Load
| OperatingProviderCmsSpecialtyName |
"*Not Applicable" |
CMS CJR DME Claim Load
| OperatingProviderCmsSpecialtyName |
*Not Applicable |
CMS CJR Home Health Claim Load
| OperatingProviderCmsSpecialtyName |
*Not Applicable |
CMS CJR Hospice Claim Load
| OperatingProviderCmsSpecialtyName |
*Not Applicable |
CMS CJR Inpatient Claim Load
| OperatingProviderCmsSpecialtyName |
*Not Applicable |
CMS CJR Outpatient Claim Load
| OperatingProviderCmsSpecialtyName |
*Not Applicable |
CMS CJR Part B Claim Load
| OperatingProviderCmsSpecialtyName |
*Not Applicable |
CMS CJR Skilled Nursing Facility Claim Load
| OperatingProviderCmsSpecialtyName |
*Not Applicable |
Data Aggregation Medical Claim Load
| OperatingProviderCmsSpecialtyName |
NULL |
Data Aggregation Pharmacy Claim Load
| OperatingProviderCmsSpecialtyName |
"*Not Applicable" |
Externally Adjudicated Medical Claim Load
| OperatingProviderCmsSpecialtyName |
NULL |
Externally Adjudicated Pharmacy Claim Load
| OperatingProviderCmsSpecialtyName |
"*Not Applicable" |
Payer System Medical Claim Load
| OperatingProviderCmsSpecialtyName |
NULL |
Payer System Pharmacy Claim Load
| OperatingProviderCmsSpecialtyName |
"*Not Applicable" |
Received Claim Load
| OperatingProviderCmsSpecialtyName |
NULL |
Received Pharmacy Claim Load
| OperatingProviderCmsSpecialtyName |
"*Not Applicable" |
OtherProviderCmsSpecialtyCode
: stringCenters for Medicare & Medicaid Services (CMS) code for the specialty of the other provider
Properties
- Data type
- string
- SQL Server data type
- nvarchar(50)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| OtherProviderCmsSpecialtyCode |
"*Not Applicable" |
CMS ACO Part B DME File Load
| OtherProviderCmsSpecialtyCode |
"*Not Applicable" |
CMS ACO Part B Physicians File Load
| OtherProviderCmsSpecialtyCode |
"*Not Applicable" |
CMS ACO Part D Prescription Drug File Load
| OtherProviderCmsSpecialtyCode |
"*Not Applicable" |
CMS CJR DME Claim Load
| OtherProviderCmsSpecialtyCode |
*Not Applicable |
CMS CJR Home Health Claim Load
| OtherProviderCmsSpecialtyCode |
*Not Applicable |
CMS CJR Hospice Claim Load
| OtherProviderCmsSpecialtyCode |
*Not Applicable |
CMS CJR Inpatient Claim Load
| OtherProviderCmsSpecialtyCode |
*Not Applicable |
CMS CJR Outpatient Claim Load
| OtherProviderCmsSpecialtyCode |
*Not Applicable |
CMS CJR Part B Claim Load
| OtherProviderCmsSpecialtyCode |
*Not Applicable |
CMS CJR Skilled Nursing Facility Claim Load
| OtherProviderCmsSpecialtyCode |
*Not Applicable |
Data Aggregation Medical Claim Load
| OtherProviderCmsSpecialtyCode |
NULL |
Data Aggregation Pharmacy Claim Load
| OtherProviderCmsSpecialtyCode |
"*Not Applicable" |
Externally Adjudicated Medical Claim Load
| OtherProviderCmsSpecialtyCode |
NULL |
Externally Adjudicated Pharmacy Claim Load
| OtherProviderCmsSpecialtyCode |
"*Not Applicable" |
Payer System Medical Claim Load
| OtherProviderCmsSpecialtyCode |
NULL |
Payer System Pharmacy Claim Load
| OtherProviderCmsSpecialtyCode |
"*Not Applicable" |
Received Claim Load
| OtherProviderCmsSpecialtyCode |
NULL |
Received Pharmacy Claim Load
| OtherProviderCmsSpecialtyCode |
"*Not Applicable" |
OtherProviderCmsSpecialtyName
: stringCenters for Medicare & Medicaid Services (CMS) name for the specialty of the other provider
Properties
- Data type
- string
- SQL Server data type
- nvarchar(300)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| OtherProviderCmsSpecialtyName |
"*Not Applicable" |
CMS ACO Part B DME File Load
| OtherProviderCmsSpecialtyName |
"*Not Applicable" |
CMS ACO Part B Physicians File Load
| OtherProviderCmsSpecialtyName |
"*Not Applicable" |
CMS ACO Part D Prescription Drug File Load
| OtherProviderCmsSpecialtyName |
"*Not Applicable" |
CMS CJR DME Claim Load
| OtherProviderCmsSpecialtyName |
*Not Applicable |
CMS CJR Home Health Claim Load
| OtherProviderCmsSpecialtyName |
*Not Applicable |
CMS CJR Hospice Claim Load
| OtherProviderCmsSpecialtyName |
*Not Applicable |
CMS CJR Inpatient Claim Load
| OtherProviderCmsSpecialtyName |
*Not Applicable |
CMS CJR Outpatient Claim Load
| OtherProviderCmsSpecialtyName |
*Not Applicable |
CMS CJR Part B Claim Load
| OtherProviderCmsSpecialtyName |
*Not Applicable |
CMS CJR Skilled Nursing Facility Claim Load
| OtherProviderCmsSpecialtyName |
*Not Applicable |
Data Aggregation Medical Claim Load
| OtherProviderCmsSpecialtyName |
NULL |
Data Aggregation Pharmacy Claim Load
| OtherProviderCmsSpecialtyName |
"*Not Applicable" |
Externally Adjudicated Medical Claim Load
| OtherProviderCmsSpecialtyName |
NULL |
Externally Adjudicated Pharmacy Claim Load
| OtherProviderCmsSpecialtyName |
"*Not Applicable" |
Payer System Medical Claim Load
| OtherProviderCmsSpecialtyName |
NULL |
Payer System Pharmacy Claim Load
| OtherProviderCmsSpecialtyName |
"*Not Applicable" |
Received Claim Load
| OtherProviderCmsSpecialtyName |
NULL |
Received Pharmacy Claim Load
| OtherProviderCmsSpecialtyName |
"*Not Applicable" |
BillingProviderTaxonomyCode
: stringThe NUCC taxonomy code for the provider under whose license number the claim was sent
Properties
- Data type
- string
- SQL Server data type
- nvarchar(50)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| BillingProviderTaxonomyCode |
"*Not Applicable" |
CMS ACO Part B DME File Load
| BillingProviderTaxonomyCode |
"*Not Applicable" |
CMS ACO Part B Physicians File Load
| BillingProviderTaxonomyCode |
"*Not Applicable" |
CMS ACO Part D Prescription Drug File Load
| BillingProviderTaxonomyCode |
"*Not Applicable" |
CMS CJR DME Claim Load
| BillingProviderTaxonomyCode |
*Not Applicable |
CMS CJR Home Health Claim Load
| BillingProviderTaxonomyCode |
*Not Applicable |
CMS CJR Hospice Claim Load
| BillingProviderTaxonomyCode |
*Not Applicable |
CMS CJR Inpatient Claim Load
| BillingProviderTaxonomyCode |
*Not Applicable |
CMS CJR Outpatient Claim Load
| BillingProviderTaxonomyCode |
*Not Applicable |
CMS CJR Part B Claim Load
| BillingProviderTaxonomyCode |
*Not Applicable |
CMS CJR Skilled Nursing Facility Claim Load
| BillingProviderTaxonomyCode |
*Not Applicable |
Data Aggregation Medical Claim Load
| BillingProviderTaxonomyCode |
|
||||
Data Aggregation Pharmacy Claim Load
| BillingProviderTaxonomyCode |
"*Not Applicable" |
Externally Adjudicated Pharmacy Claim Load
| BillingProviderTaxonomyCode |
"*Not Applicable" |
Payer System Medical Claim Load
| BillingProviderTaxonomyCode |
|
||||
Payer System Pharmacy Claim Load
| BillingProviderTaxonomyCode |
"*Not Applicable" |
Received Claim Load
| BillingProviderTaxonomyCode |
|
||||
Received Pharmacy Claim Load
| BillingProviderTaxonomyCode |
"*Not Applicable" |
BillingProviderTaxonomyName
: stringName of the NUCC taxonomy code for the provider under whose license number the claim was sent
Properties
- Data type
- string
- SQL Server data type
- nvarchar(300)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| BillingProviderTaxonomyName |
"*Not Applicable" |
CMS ACO Part B DME File Load
| BillingProviderTaxonomyName |
"*Not Applicable" |
CMS ACO Part B Physicians File Load
| BillingProviderTaxonomyName |
"*Not Applicable" |
CMS ACO Part D Prescription Drug File Load
| BillingProviderTaxonomyName |
"*Not Applicable" |
CMS CJR DME Claim Load
| BillingProviderTaxonomyName |
*Not Applicable |
CMS CJR Home Health Claim Load
| BillingProviderTaxonomyName |
*Not Applicable |
CMS CJR Hospice Claim Load
| BillingProviderTaxonomyName |
*Not Applicable |
CMS CJR Inpatient Claim Load
| BillingProviderTaxonomyName |
*Not Applicable |
CMS CJR Outpatient Claim Load
| BillingProviderTaxonomyName |
*Not Applicable |
CMS CJR Part B Claim Load
| BillingProviderTaxonomyName |
*Not Applicable |
CMS CJR Skilled Nursing Facility Claim Load
| BillingProviderTaxonomyName |
*Not Applicable |
Data Aggregation Medical Claim Load
| BillingProviderTaxonomyName |
NULL |
Data Aggregation Pharmacy Claim Load
| BillingProviderTaxonomyName |
"*Not Applicable" |
Externally Adjudicated Medical Claim Load
| BillingProviderTaxonomyName |
NULL |
Externally Adjudicated Pharmacy Claim Load
| BillingProviderTaxonomyName |
"*Not Applicable" |
Payer System Medical Claim Load
| BillingProviderTaxonomyName |
NULL |
Payer System Pharmacy Claim Load
| BillingProviderTaxonomyName |
"*Not Applicable" |
Received Claim Load
| BillingProviderTaxonomyName |
NULL |
Received Pharmacy Claim Load
| BillingProviderTaxonomyName |
"*Not Applicable" |
ReferringProviderTaxonomyCode
: stringThe NUCC taxonomy code for the provider who referred the patient to another provider
Properties
- Data type
- string
- SQL Server data type
- nvarchar(50)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| ReferringProviderTaxonomyCode |
"*Not Applicable" |
CMS ACO Part B DME File Load
| ReferringProviderTaxonomyCode |
"*Not Applicable" |
CMS ACO Part B Physicians File Load
| ReferringProviderTaxonomyCode |
"*Not Applicable" |
CMS ACO Part D Prescription Drug File Load
| ReferringProviderTaxonomyCode |
"*Not Applicable" |
CMS CJR DME Claim Load
| ReferringProviderTaxonomyCode |
*Not Applicable |
CMS CJR Home Health Claim Load
| ReferringProviderTaxonomyCode |
*Not Applicable |
CMS CJR Hospice Claim Load
| ReferringProviderTaxonomyCode |
*Not Applicable |
CMS CJR Inpatient Claim Load
| ReferringProviderTaxonomyCode |
*Not Applicable |
CMS CJR Outpatient Claim Load
| ReferringProviderTaxonomyCode |
*Not Applicable |
CMS CJR Part B Claim Load
| ReferringProviderTaxonomyCode |
*Not Applicable |
CMS CJR Skilled Nursing Facility Claim Load
| ReferringProviderTaxonomyCode |
*Not Applicable |
Data Aggregation Medical Claim Load
| ReferringProviderTaxonomyCode |
|
||
Data Aggregation Pharmacy Claim Load
| ReferringProviderTaxonomyCode |
"*Not Applicable" |
Externally Adjudicated Pharmacy Claim Load
| ReferringProviderTaxonomyCode |
"*Not Applicable" |
Payer System Medical Claim Load
| ReferringProviderTaxonomyCode |
|
||
Payer System Pharmacy Claim Load
| ReferringProviderTaxonomyCode |
"*Not Applicable" |
Received Claim Load
| ReferringProviderTaxonomyCode |
|
||
Received Pharmacy Claim Load
| ReferringProviderTaxonomyCode |
"*Not Applicable" |
ReferringProviderTaxonomyName
: stringName of the NUCC taxonomy code for the provider who referred the patient to another provider
Properties
- Data type
- string
- SQL Server data type
- nvarchar(300)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| ReferringProviderTaxonomyName |
"*Not Applicable" |
CMS ACO Part B DME File Load
| ReferringProviderTaxonomyName |
"*Not Applicable" |
CMS ACO Part B Physicians File Load
| ReferringProviderTaxonomyName |
"*Not Applicable" |
CMS ACO Part D Prescription Drug File Load
| ReferringProviderTaxonomyName |
"*Not Applicable" |
CMS CJR DME Claim Load
| ReferringProviderTaxonomyName |
*Not Applicable |
CMS CJR Home Health Claim Load
| ReferringProviderTaxonomyName |
*Not Applicable |
CMS CJR Hospice Claim Load
| ReferringProviderTaxonomyName |
*Not Applicable |
CMS CJR Inpatient Claim Load
| ReferringProviderTaxonomyName |
*Not Applicable |
CMS CJR Outpatient Claim Load
| ReferringProviderTaxonomyName |
*Not Applicable |
CMS CJR Part B Claim Load
| ReferringProviderTaxonomyName |
*Not Applicable |
CMS CJR Skilled Nursing Facility Claim Load
| ReferringProviderTaxonomyName |
*Not Applicable |
Data Aggregation Medical Claim Load
| ReferringProviderTaxonomyName |
NULL |
Data Aggregation Pharmacy Claim Load
| ReferringProviderTaxonomyName |
"*Not Applicable" |
Externally Adjudicated Medical Claim Load
| ReferringProviderTaxonomyName |
NULL |
Externally Adjudicated Pharmacy Claim Load
| ReferringProviderTaxonomyName |
"*Not Applicable" |
Payer System Medical Claim Load
| ReferringProviderTaxonomyName |
NULL |
Payer System Pharmacy Claim Load
| ReferringProviderTaxonomyName |
"*Not Applicable" |
Received Claim Load
| ReferringProviderTaxonomyName |
NULL |
Received Pharmacy Claim Load
| ReferringProviderTaxonomyName |
"*Not Applicable" |
RenderingProviderTaxonomyCode
: stringThe NUCC taxonomy code for the provider who rendered the care
Properties
- Data type
- string
- SQL Server data type
- nvarchar(50)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| RenderingProviderTaxonomyCode |
"*Not Applicable" |
CMS ACO Part B DME File Load
| RenderingProviderTaxonomyCode |
"*Not Applicable" |
CMS ACO Part B Physicians File Load
| RenderingProviderTaxonomyCode |
"*Not Applicable" |
CMS ACO Part D Prescription Drug File Load
| RenderingProviderTaxonomyCode |
"*Not Applicable" |
CMS CJR DME Claim Load
| RenderingProviderTaxonomyCode |
*Not Applicable |
CMS CJR Home Health Claim Load
| RenderingProviderTaxonomyCode |
*Not Applicable |
CMS CJR Hospice Claim Load
| RenderingProviderTaxonomyCode |
*Not Applicable |
CMS CJR Inpatient Claim Load
| RenderingProviderTaxonomyCode |
*Not Applicable |
CMS CJR Outpatient Claim Load
| RenderingProviderTaxonomyCode |
*Not Applicable |
CMS CJR Part B Claim Load
| RenderingProviderTaxonomyCode |
*Not Applicable |
CMS CJR Skilled Nursing Facility Claim Load
| RenderingProviderTaxonomyCode |
*Not Applicable |
Data Aggregation Pharmacy Claim Load
| RenderingProviderTaxonomyCode |
"*Not Applicable" |
Externally Adjudicated Medical Claim Load
| RenderingProviderTaxonomyCode |
|
||
Externally Adjudicated Pharmacy Claim Load
| RenderingProviderTaxonomyCode |
"*Not Applicable" |
Payer System Pharmacy Claim Load
| RenderingProviderTaxonomyCode |
"*Not Applicable" |
Received Claim Load
| RenderingProviderTaxonomyCode |
|
||||||||||||||||||
|
If REND_PROV_NPI is not NULL then REND_PROV_TAXONOMY Otherwise if RENDERING_PROV_ID is not NULL then NULL Otherwise if CLAIM_FORMAT = 1 and DENTAL_INFO_YN = "Y" and ASST_SURG_NPI is not NULL then ASST_SURG_TAXONOMY Otherwise if CLAIM_FORMAT = 1 and BIL_PROV_NPI is not NULL then BIL_PROV_TAXONOMY |
Received Pharmacy Claim Load
| RenderingProviderTaxonomyCode |
"*Not Applicable" |
RenderingProviderTaxonomyName
: stringName of the NUCC taxonomy code for the provider who rendered the care
Properties
- Data type
- string
- SQL Server data type
- nvarchar(300)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| RenderingProviderTaxonomyName |
"*Not Applicable" |
CMS ACO Part B DME File Load
| RenderingProviderTaxonomyName |
"*Not Applicable" |
CMS ACO Part B Physicians File Load
| RenderingProviderTaxonomyName |
"*Not Applicable" |
CMS ACO Part D Prescription Drug File Load
| RenderingProviderTaxonomyName |
"*Not Applicable" |
CMS CJR DME Claim Load
| RenderingProviderTaxonomyName |
*Not Applicable |
CMS CJR Home Health Claim Load
| RenderingProviderTaxonomyName |
*Not Applicable |
CMS CJR Hospice Claim Load
| RenderingProviderTaxonomyName |
*Not Applicable |
CMS CJR Inpatient Claim Load
| RenderingProviderTaxonomyName |
*Not Applicable |
CMS CJR Outpatient Claim Load
| RenderingProviderTaxonomyName |
*Not Applicable |
CMS CJR Part B Claim Load
| RenderingProviderTaxonomyName |
*Not Applicable |
CMS CJR Skilled Nursing Facility Claim Load
| RenderingProviderTaxonomyName |
*Not Applicable |
Data Aggregation Medical Claim Load
| RenderingProviderTaxonomyName |
NULL |
Data Aggregation Pharmacy Claim Load
| RenderingProviderTaxonomyName |
"*Not Applicable" |
Externally Adjudicated Medical Claim Load
| RenderingProviderTaxonomyName |
NULL |
Externally Adjudicated Pharmacy Claim Load
| RenderingProviderTaxonomyName |
"*Not Applicable" |
Payer System Medical Claim Load
| RenderingProviderTaxonomyName |
NULL |
Payer System Pharmacy Claim Load
| RenderingProviderTaxonomyName |
"*Not Applicable" |
Received Claim Load
| RenderingProviderTaxonomyName |
NULL |
Received Pharmacy Claim Load
| RenderingProviderTaxonomyName |
"*Not Applicable" |
AttendingProviderTaxonomyCode
: stringThe NUCC taxonomy code for the provider who managed the overall care of the admitted patient
Properties
- Data type
- string
- SQL Server data type
- nvarchar(50)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| AttendingProviderTaxonomyCode |
"*Not Applicable" |
CMS ACO Part B DME File Load
| AttendingProviderTaxonomyCode |
"*Not Applicable" |
CMS ACO Part B Physicians File Load
| AttendingProviderTaxonomyCode |
"*Not Applicable" |
CMS ACO Part D Prescription Drug File Load
| AttendingProviderTaxonomyCode |
"*Not Applicable" |
CMS CJR DME Claim Load
| AttendingProviderTaxonomyCode |
*Not Applicable |
CMS CJR Home Health Claim Load
| AttendingProviderTaxonomyCode |
*Not Applicable |
CMS CJR Hospice Claim Load
| AttendingProviderTaxonomyCode |
*Not Applicable |
CMS CJR Inpatient Claim Load
| AttendingProviderTaxonomyCode |
*Not Applicable |
CMS CJR Outpatient Claim Load
| AttendingProviderTaxonomyCode |
*Not Applicable |
CMS CJR Part B Claim Load
| AttendingProviderTaxonomyCode |
*Not Applicable |
CMS CJR Skilled Nursing Facility Claim Load
| AttendingProviderTaxonomyCode |
*Not Applicable |
Data Aggregation Medical Claim Load
| AttendingProviderTaxonomyCode |
|
||
Data Aggregation Pharmacy Claim Load
| AttendingProviderTaxonomyCode |
"*Not Applicable" |
Externally Adjudicated Medical Claim Load
| AttendingProviderTaxonomyCode |
|
||
Externally Adjudicated Pharmacy Claim Load
| AttendingProviderTaxonomyCode |
"*Not Applicable" |
Payer System Medical Claim Load
| AttendingProviderTaxonomyCode |
|
||
Payer System Pharmacy Claim Load
| AttendingProviderTaxonomyCode |
"*Not Applicable" |
Received Claim Load
| AttendingProviderTaxonomyCode |
|
||
Received Pharmacy Claim Load
| AttendingProviderTaxonomyCode |
"*Not Applicable" |
AttendingProviderTaxonomyName
: stringName of the NUCC taxonomy code for the provider who managed the overall care of the admitted patient
Properties
- Data type
- string
- SQL Server data type
- nvarchar(300)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| AttendingProviderTaxonomyName |
"*Not Applicable" |
CMS ACO Part B DME File Load
| AttendingProviderTaxonomyName |
"*Not Applicable" |
CMS ACO Part B Physicians File Load
| AttendingProviderTaxonomyName |
"*Not Applicable" |
CMS ACO Part D Prescription Drug File Load
| AttendingProviderTaxonomyName |
"*Not Applicable" |
CMS CJR DME Claim Load
| AttendingProviderTaxonomyName |
*Not Applicable |
CMS CJR Home Health Claim Load
| AttendingProviderTaxonomyName |
*Not Applicable |
CMS CJR Hospice Claim Load
| AttendingProviderTaxonomyName |
*Not Applicable |
CMS CJR Inpatient Claim Load
| AttendingProviderTaxonomyName |
*Not Applicable |
CMS CJR Outpatient Claim Load
| AttendingProviderTaxonomyName |
*Not Applicable |
CMS CJR Part B Claim Load
| AttendingProviderTaxonomyName |
*Not Applicable |
CMS CJR Skilled Nursing Facility Claim Load
| AttendingProviderTaxonomyName |
*Not Applicable |
Data Aggregation Medical Claim Load
| AttendingProviderTaxonomyName |
NULL |
Data Aggregation Pharmacy Claim Load
| AttendingProviderTaxonomyName |
"*Not Applicable" |
Externally Adjudicated Medical Claim Load
| AttendingProviderTaxonomyName |
NULL |
Externally Adjudicated Pharmacy Claim Load
| AttendingProviderTaxonomyName |
"*Not Applicable" |
Payer System Medical Claim Load
| AttendingProviderTaxonomyName |
NULL |
Payer System Pharmacy Claim Load
| AttendingProviderTaxonomyName |
"*Not Applicable" |
Received Claim Load
| AttendingProviderTaxonomyName |
NULL |
Received Pharmacy Claim Load
| AttendingProviderTaxonomyName |
"*Not Applicable" |
OperatingProviderTaxonomyCode
: stringTaxonomy code for the provider who had the primary responsibility for performing the surgical procedure
Properties
- Data type
- string
- SQL Server data type
- nvarchar(50)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| OperatingProviderTaxonomyCode |
"*Not Applicable" |
CMS ACO Part B DME File Load
| OperatingProviderTaxonomyCode |
"*Not Applicable" |
CMS ACO Part B Physicians File Load
| OperatingProviderTaxonomyCode |
"*Not Applicable" |
CMS ACO Part D Prescription Drug File Load
| OperatingProviderTaxonomyCode |
"*Not Applicable" |
CMS CJR DME Claim Load
| OperatingProviderTaxonomyCode |
*Not Applicable |
CMS CJR Home Health Claim Load
| OperatingProviderTaxonomyCode |
*Not Applicable |
CMS CJR Hospice Claim Load
| OperatingProviderTaxonomyCode |
*Not Applicable |
CMS CJR Inpatient Claim Load
| OperatingProviderTaxonomyCode |
*Not Applicable |
CMS CJR Outpatient Claim Load
| OperatingProviderTaxonomyCode |
*Not Applicable |
CMS CJR Part B Claim Load
| OperatingProviderTaxonomyCode |
*Not Applicable |
CMS CJR Skilled Nursing Facility Claim Load
| OperatingProviderTaxonomyCode |
*Not Applicable |
Data Aggregation Medical Claim Load
| OperatingProviderTaxonomyCode |
|
||
Data Aggregation Pharmacy Claim Load
| OperatingProviderTaxonomyCode |
"*Not Applicable" |
Externally Adjudicated Medical Claim Load
| OperatingProviderTaxonomyCode |
"*Not Applicable" |
Externally Adjudicated Pharmacy Claim Load
| OperatingProviderTaxonomyCode |
"*Not Applicable" |
Payer System Medical Claim Load
| OperatingProviderTaxonomyCode |
|
||
Payer System Pharmacy Claim Load
| OperatingProviderTaxonomyCode |
"*Not Applicable" |
Received Claim Load
| OperatingProviderTaxonomyCode |
"*Not Applicable" |
Received Pharmacy Claim Load
| OperatingProviderTaxonomyCode |
"*Not Applicable" |
OperatingProviderTaxonomyName
: stringName of the taxonomy code for the provider who had the primary responsibility for performing the surgical procedure
Properties
- Data type
- string
- SQL Server data type
- nvarchar(300)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| OperatingProviderTaxonomyName |
"*Not Applicable" |
CMS ACO Part B DME File Load
| OperatingProviderTaxonomyName |
"*Not Applicable" |
CMS ACO Part B Physicians File Load
| OperatingProviderTaxonomyName |
"*Not Applicable" |
CMS ACO Part D Prescription Drug File Load
| OperatingProviderTaxonomyName |
"*Not Applicable" |
CMS CJR DME Claim Load
| OperatingProviderTaxonomyName |
*Not Applicable |
CMS CJR Home Health Claim Load
| OperatingProviderTaxonomyName |
*Not Applicable |
CMS CJR Hospice Claim Load
| OperatingProviderTaxonomyName |
*Not Applicable |
CMS CJR Inpatient Claim Load
| OperatingProviderTaxonomyName |
*Not Applicable |
CMS CJR Outpatient Claim Load
| OperatingProviderTaxonomyName |
*Not Applicable |
CMS CJR Part B Claim Load
| OperatingProviderTaxonomyName |
*Not Applicable |
CMS CJR Skilled Nursing Facility Claim Load
| OperatingProviderTaxonomyName |
*Not Applicable |
Data Aggregation Medical Claim Load
| OperatingProviderTaxonomyName |
NULL |
Data Aggregation Pharmacy Claim Load
| OperatingProviderTaxonomyName |
"*Not Applicable" |
Externally Adjudicated Medical Claim Load
| OperatingProviderTaxonomyName |
NULL |
Externally Adjudicated Pharmacy Claim Load
| OperatingProviderTaxonomyName |
"*Not Applicable" |
Payer System Medical Claim Load
| OperatingProviderTaxonomyName |
NULL |
Payer System Pharmacy Claim Load
| OperatingProviderTaxonomyName |
"*Not Applicable" |
Received Claim Load
| OperatingProviderTaxonomyName |
NULL |
Received Pharmacy Claim Load
| OperatingProviderTaxonomyName |
"*Not Applicable" |
OtherProviderTaxonomyCode
: stringTaxonomy code for the other provider
Properties
- Data type
- string
- SQL Server data type
- nvarchar(50)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| OtherProviderTaxonomyCode |
"*Not Applicable" |
CMS ACO Part B DME File Load
| OtherProviderTaxonomyCode |
"*Not Applicable" |
CMS ACO Part B Physicians File Load
| OtherProviderTaxonomyCode |
"*Not Applicable" |
CMS ACO Part D Prescription Drug File Load
| OtherProviderTaxonomyCode |
"*Not Applicable" |
CMS CJR DME Claim Load
| OtherProviderTaxonomyCode |
*Not Applicable |
CMS CJR Home Health Claim Load
| OtherProviderTaxonomyCode |
*Not Applicable |
CMS CJR Hospice Claim Load
| OtherProviderTaxonomyCode |
*Not Applicable |
CMS CJR Inpatient Claim Load
| OtherProviderTaxonomyCode |
*Not Applicable |
CMS CJR Outpatient Claim Load
| OtherProviderTaxonomyCode |
*Not Applicable |
CMS CJR Part B Claim Load
| OtherProviderTaxonomyCode |
*Not Applicable |
CMS CJR Skilled Nursing Facility Claim Load
| OtherProviderTaxonomyCode |
*Not Applicable |
Data Aggregation Medical Claim Load
| OtherProviderTaxonomyCode |
"*Not Applicable" |
Data Aggregation Pharmacy Claim Load
| OtherProviderTaxonomyCode |
"*Not Applicable" |
Externally Adjudicated Medical Claim Load
| OtherProviderTaxonomyCode |
"*Not Applicable" |
Externally Adjudicated Pharmacy Claim Load
| OtherProviderTaxonomyCode |
"*Not Applicable" |
Payer System Medical Claim Load
| OtherProviderTaxonomyCode |
"*Not Applicable" |
Payer System Pharmacy Claim Load
| OtherProviderTaxonomyCode |
"*Not Applicable" |
Received Claim Load
| OtherProviderTaxonomyCode |
"*Not Applicable" |
Received Pharmacy Claim Load
| OtherProviderTaxonomyCode |
"*Not Applicable" |
OtherProviderTaxonomyName
: stringName of the taxonomy code for the other provider
Properties
- Data type
- string
- SQL Server data type
- nvarchar(300)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| OtherProviderTaxonomyName |
"*Not Applicable" |
CMS ACO Part B DME File Load
| OtherProviderTaxonomyName |
"*Not Applicable" |
CMS ACO Part B Physicians File Load
| OtherProviderTaxonomyName |
"*Not Applicable" |
CMS ACO Part D Prescription Drug File Load
| OtherProviderTaxonomyName |
"*Not Applicable" |
CMS CJR DME Claim Load
| OtherProviderTaxonomyName |
*Not Applicable |
CMS CJR Home Health Claim Load
| OtherProviderTaxonomyName |
*Not Applicable |
CMS CJR Hospice Claim Load
| OtherProviderTaxonomyName |
*Not Applicable |
CMS CJR Inpatient Claim Load
| OtherProviderTaxonomyName |
*Not Applicable |
CMS CJR Outpatient Claim Load
| OtherProviderTaxonomyName |
*Not Applicable |
CMS CJR Part B Claim Load
| OtherProviderTaxonomyName |
*Not Applicable |
CMS CJR Skilled Nursing Facility Claim Load
| OtherProviderTaxonomyName |
*Not Applicable |
Data Aggregation Medical Claim Load
| OtherProviderTaxonomyName |
NULL |
Data Aggregation Pharmacy Claim Load
| OtherProviderTaxonomyName |
"*Not Applicable" |
Externally Adjudicated Medical Claim Load
| OtherProviderTaxonomyName |
NULL |
Externally Adjudicated Pharmacy Claim Load
| OtherProviderTaxonomyName |
"*Not Applicable" |
Payer System Medical Claim Load
| OtherProviderTaxonomyName |
NULL |
Payer System Pharmacy Claim Load
| OtherProviderTaxonomyName |
"*Not Applicable" |
Received Claim Load
| OtherProviderTaxonomyName |
NULL |
Received Pharmacy Claim Load
| OtherProviderTaxonomyName |
"*Not Applicable" |
FirstClaimTrait
: stringFirst trait associated with the claim
Properties
- Data type
- string
- SQL Server data type
- nvarchar(300)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| FirstClaimTrait |
"*Not Applicable" |
CMS ACO Part B DME File Load
| FirstClaimTrait |
"*Not Applicable" |
CMS ACO Part B Physicians File Load
| FirstClaimTrait |
"*Not Applicable" |
CMS ACO Part D Prescription Drug File Load
| FirstClaimTrait |
"*Not Applicable" |
CMS CJR DME Claim Load
| FirstClaimTrait |
NULL |
CMS CJR Home Health Claim Load
| FirstClaimTrait |
NULL |
CMS CJR Hospice Claim Load
| FirstClaimTrait |
NULL |
CMS CJR Inpatient Claim Load
| FirstClaimTrait |
NULL |
CMS CJR Outpatient Claim Load
| FirstClaimTrait |
NULL |
CMS CJR Part B Claim Load
| FirstClaimTrait |
NULL |
CMS CJR Skilled Nursing Facility Claim Load
| FirstClaimTrait |
NULL |
Data Aggregation Pharmacy Claim Load
| FirstClaimTrait |
"*Unspecified" |
Externally Adjudicated Pharmacy Claim Load
| FirstClaimTrait |
"*Unspecified" |
Payer System Pharmacy Claim Load
| FirstClaimTrait |
"*Unspecified" |
Received Claim Load
| FirstClaimTrait |
|
||||||
|
If AP_CLAIM_2.CLM_TRAIT_1_C is NULL then "*Unspecified" Otherwise if ZC_CLM_TRAIT_1.CLM_TRAIT_1_C is NULL then "*Unknown" Otherwise ZC_CLM_TRAIT_1.NAME |
Received Pharmacy Claim Load
| FirstClaimTrait |
"*Unspecified" |
SecondClaimTrait
: stringSecond trait associated with the claim
Properties
- Data type
- string
- SQL Server data type
- nvarchar(300)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| SecondClaimTrait |
"*Not Applicable" |
CMS ACO Part B DME File Load
| SecondClaimTrait |
"*Not Applicable" |
CMS ACO Part B Physicians File Load
| SecondClaimTrait |
"*Not Applicable" |
CMS ACO Part D Prescription Drug File Load
| SecondClaimTrait |
"*Not Applicable" |
CMS CJR DME Claim Load
| SecondClaimTrait |
NULL |
CMS CJR Home Health Claim Load
| SecondClaimTrait |
NULL |
CMS CJR Hospice Claim Load
| SecondClaimTrait |
NULL |
CMS CJR Inpatient Claim Load
| SecondClaimTrait |
NULL |
CMS CJR Outpatient Claim Load
| SecondClaimTrait |
NULL |
CMS CJR Part B Claim Load
| SecondClaimTrait |
NULL |
CMS CJR Skilled Nursing Facility Claim Load
| SecondClaimTrait |
NULL |
Data Aggregation Pharmacy Claim Load
| SecondClaimTrait |
"*Unspecified" |
Externally Adjudicated Pharmacy Claim Load
| SecondClaimTrait |
"*Unspecified" |
Payer System Pharmacy Claim Load
| SecondClaimTrait |
"*Unspecified" |
Received Claim Load
| SecondClaimTrait |
|
||||||
|
If AP_CLAIM_2.CLM_TRAIT_2_C is NULL then "*Unspecified" Otherwise if ZC_CLM_TRAIT_2.CLM_TRAIT_2_C is NULL then "*Unknown" Otherwise ZC_CLM_TRAIT_2.NAME |
Received Pharmacy Claim Load
| SecondClaimTrait |
"*Unspecified" |
ThirdClaimTrait
: stringThird trait associated with the claim
Properties
- Data type
- string
- SQL Server data type
- nvarchar(300)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| ThirdClaimTrait |
"*Not Applicable" |
CMS ACO Part B DME File Load
| ThirdClaimTrait |
"*Not Applicable" |
CMS ACO Part B Physicians File Load
| ThirdClaimTrait |
"*Not Applicable" |
CMS ACO Part D Prescription Drug File Load
| ThirdClaimTrait |
"*Not Applicable" |
CMS CJR DME Claim Load
| ThirdClaimTrait |
NULL |
CMS CJR Home Health Claim Load
| ThirdClaimTrait |
NULL |
CMS CJR Hospice Claim Load
| ThirdClaimTrait |
NULL |
CMS CJR Inpatient Claim Load
| ThirdClaimTrait |
NULL |
CMS CJR Outpatient Claim Load
| ThirdClaimTrait |
NULL |
CMS CJR Part B Claim Load
| ThirdClaimTrait |
NULL |
CMS CJR Skilled Nursing Facility Claim Load
| ThirdClaimTrait |
NULL |
Data Aggregation Pharmacy Claim Load
| ThirdClaimTrait |
"*Unspecified" |
Externally Adjudicated Pharmacy Claim Load
| ThirdClaimTrait |
"*Unspecified" |
Payer System Pharmacy Claim Load
| ThirdClaimTrait |
"*Unspecified" |
Received Claim Load
| ThirdClaimTrait |
|
||||||
|
If AP_CLAIM_2.CLM_TRAIT_3_C is NULL then "*Unspecified" Otherwise if ZC_CLM_TRAIT_3.CLM_TRAIT_3_C is NULL then "*Unknown" Otherwise ZC_CLM_TRAIT_3.NAME |
Received Pharmacy Claim Load
| ThirdClaimTrait |
"*Unspecified" |
FourthClaimTrait
: stringFourth trait associated with the claim
Properties
- Data type
- string
- SQL Server data type
- nvarchar(300)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| FourthClaimTrait |
"*Not Applicable" |
CMS ACO Part B DME File Load
| FourthClaimTrait |
"*Not Applicable" |
CMS ACO Part B Physicians File Load
| FourthClaimTrait |
"*Not Applicable" |
CMS ACO Part D Prescription Drug File Load
| FourthClaimTrait |
"*Not Applicable" |
CMS CJR DME Claim Load
| FourthClaimTrait |
NULL |
CMS CJR Home Health Claim Load
| FourthClaimTrait |
NULL |
CMS CJR Hospice Claim Load
| FourthClaimTrait |
NULL |
CMS CJR Inpatient Claim Load
| FourthClaimTrait |
NULL |
CMS CJR Outpatient Claim Load
| FourthClaimTrait |
NULL |
CMS CJR Part B Claim Load
| FourthClaimTrait |
NULL |
CMS CJR Skilled Nursing Facility Claim Load
| FourthClaimTrait |
NULL |
Data Aggregation Pharmacy Claim Load
| FourthClaimTrait |
"*Unspecified" |
Externally Adjudicated Pharmacy Claim Load
| FourthClaimTrait |
"*Unspecified" |
Payer System Pharmacy Claim Load
| FourthClaimTrait |
"*Unspecified" |
Received Claim Load
| FourthClaimTrait |
|
||||||
|
If AP_CLAIM_2.CLM_TRAIT_4_C is NULL then "*Unspecified" Otherwise if ZC_CLM_TRAIT_4.CLM_TRAIT_4_C is NULL then "*Unknown" Otherwise ZC_CLM_TRAIT_4.NAME |
Received Pharmacy Claim Load
| FourthClaimTrait |
"*Unspecified" |
FifthClaimTrait
: stringFifth trait associated with the claim
Properties
- Data type
- string
- SQL Server data type
- nvarchar(300)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| FifthClaimTrait |
"*Not Applicable" |
CMS ACO Part B DME File Load
| FifthClaimTrait |
"*Not Applicable" |
CMS ACO Part B Physicians File Load
| FifthClaimTrait |
"*Not Applicable" |
CMS ACO Part D Prescription Drug File Load
| FifthClaimTrait |
"*Not Applicable" |
CMS CJR DME Claim Load
| FifthClaimTrait |
NULL |
CMS CJR Home Health Claim Load
| FifthClaimTrait |
NULL |
CMS CJR Hospice Claim Load
| FifthClaimTrait |
NULL |
CMS CJR Inpatient Claim Load
| FifthClaimTrait |
NULL |
CMS CJR Outpatient Claim Load
| FifthClaimTrait |
NULL |
CMS CJR Part B Claim Load
| FifthClaimTrait |
NULL |
CMS CJR Skilled Nursing Facility Claim Load
| FifthClaimTrait |
NULL |
Data Aggregation Pharmacy Claim Load
| FifthClaimTrait |
"*Unspecified" |
Externally Adjudicated Pharmacy Claim Load
| FifthClaimTrait |
"*Unspecified" |
Payer System Pharmacy Claim Load
| FifthClaimTrait |
"*Unspecified" |
Received Claim Load
| FifthClaimTrait |
|
||||||
|
If AP_CLAIM_2.CLM_TRAIT_5_C is NULL then "*Unspecified" Otherwise if ZC_CLM_TRAIT_5.CLM_TRAIT_5_C is NULL then "*Unknown" Otherwise ZC_CLM_TRAIT_5.NAME |
Received Pharmacy Claim Load
| FifthClaimTrait |
"*Unspecified" |
CarrierName
: stringName of the carrier for the primary coverage associated with the claim
Properties
- Data type
- string
- SQL Server data type
- nvarchar(100)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| CarrierName |
"*Not Applicable" |
CMS ACO Part B DME File Load
| CarrierName |
"*Not Applicable" |
CMS ACO Part B Physicians File Load
| CarrierName |
"*Not Applicable" |
CMS ACO Part D Prescription Drug File Load
| CarrierName |
"*Not Applicable" |
CMS CJR DME Claim Load
| CarrierName |
NULL |
CMS CJR Home Health Claim Load
| CarrierName |
NULL |
CMS CJR Hospice Claim Load
| CarrierName |
NULL |
CMS CJR Inpatient Claim Load
| CarrierName |
NULL |
CMS CJR Outpatient Claim Load
| CarrierName |
NULL |
CMS CJR Part B Claim Load
| CarrierName |
NULL |
CMS CJR Skilled Nursing Facility Claim Load
| CarrierName |
NULL |
Data Aggregation Pharmacy Claim Load
| CarrierName |
"*Unspecified" |
Externally Adjudicated Medical Claim Load
| CarrierName |
"*Unspecified" |
Externally Adjudicated Pharmacy Claim Load
| CarrierName |
"*Unspecified" |
Payer System Pharmacy Claim Load
| CarrierName |
"*Unspecified" |
Received Claim Load
| CarrierName |
|
||||||||||||
|
If there does not exist a row in PLAN_GRP_BEN_PLAN for AP_CLAIM.PLAN_GROUP_ID effective on SERVICE_START_DATE if populated, SERV_DATE if not, then "*Unspecified" Otherwise if PLAN_GRP_BEN_PLAN.BEN_PLAN_CAR_ID is NULL then "*Unspecified" Otherwise if CARRIER_ID is NULL then "*Unknown" Otherwise CARRIER_NAME |
Received Pharmacy Claim Load
| CarrierName |
"*Unspecified" |
Ccn
: stringCenters for Medicare and Medicaid Services Certification Number (CCN) for the claim location
Properties
- Data type
- string
- SQL Server data type
- nvarchar(50)
- Allows null
- No
- Default value
- empty string
- Delete value
- empty string
Data Lineage for Each Package
CMS ACO Part A Files Load
| Ccn |
|
||
CMS ACO Part B DME File Load
| Ccn |
"*Not Applicable" |
CMS ACO Part B Physicians File Load
| Ccn |
"*Not Applicable" |
CMS ACO Part D Prescription Drug File Load
| Ccn |
"*Not Applicable" |
CMS CJR DME Claim Load
| Ccn |
NULL |
CMS CJR Home Health Claim Load
| Ccn |
|
||
CMS CJR Hospice Claim Load
| Ccn |
|
||
CMS CJR Inpatient Claim Load
| Ccn |
|
||
CMS CJR Outpatient Claim Load
| Ccn |
|
||
CMS CJR Part B Claim Load
| Ccn |
NULL |
CMS CJR Skilled Nursing Facility Claim Load
| Ccn |
|
||
Data Aggregation Medical Claim Load
| Ccn |
|
||
|
NULL |
Data Aggregation Pharmacy Claim Load
| Ccn |
"*Unspecified" |
Externally Adjudicated Medical Claim Load
| Ccn |
NULL |
Externally Adjudicated Pharmacy Claim Load
| Ccn |
"*Unspecified" |
Payer System Medical Claim Load
| Ccn |
|
||
|
NULL |
Payer System Pharmacy Claim Load
| Ccn |
"*Unspecified" |
Received Claim Load
| Ccn |
NULL |
Received Pharmacy Claim Load
| Ccn |
"*Unspecified" |
BillingProviderNpi
: stringNational Provider Identifier (NPI) of the billing provider as received on the claim
Properties
- Data type
- string
- SQL Server data type
- nvarchar(50)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| BillingProviderNpi |
CMS ACO Part B DME File Load
| BillingProviderNpi |
CMS ACO Part B Physicians File Load
| BillingProviderNpi |
CMS ACO Part D Prescription Drug File Load
| BillingProviderNpi |
CMS CJR DME Claim Load
| BillingProviderNpi |
CMS CJR Home Health Claim Load
| BillingProviderNpi |
CMS CJR Hospice Claim Load
| BillingProviderNpi |
CMS CJR Inpatient Claim Load
| BillingProviderNpi |
CMS CJR Outpatient Claim Load
| BillingProviderNpi |
CMS CJR Part B Claim Load
| BillingProviderNpi |
CMS CJR Skilled Nursing Facility Claim Load
| BillingProviderNpi |
Data Aggregation Medical Claim Load
| BillingProviderNpi |
|
||
Externally Adjudicated Medical Claim Load
| BillingProviderNpi |
|
||
Externally Adjudicated Pharmacy Claim Load
| BillingProviderNpi |
"*Not Applicable" |
Payer System Medical Claim Load
| BillingProviderNpi |
|
||
Received Claim Load
| BillingProviderNpi |
|
||
Received Pharmacy Claim Load
| BillingProviderNpi |
"*Not Applicable" |
BillingProviderName
: stringName of the billing provider as received on the claim
Properties
- Data type
- string
- SQL Server data type
- nvarchar(100)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| BillingProviderName |
CMS ACO Part B DME File Load
| BillingProviderName |
CMS ACO Part B Physicians File Load
| BillingProviderName |
CMS ACO Part D Prescription Drug File Load
| BillingProviderName |
CMS CJR DME Claim Load
| BillingProviderName |
CMS CJR Home Health Claim Load
| BillingProviderName |
CMS CJR Hospice Claim Load
| BillingProviderName |
CMS CJR Inpatient Claim Load
| BillingProviderName |
CMS CJR Outpatient Claim Load
| BillingProviderName |
CMS CJR Part B Claim Load
| BillingProviderName |
CMS CJR Skilled Nursing Facility Claim Load
| BillingProviderName |
Data Aggregation Medical Claim Load
| BillingProviderName |
|
||||
Externally Adjudicated Medical Claim Load
| BillingProviderName |
|
||||
|
If BIL_PROV_TYP_QUAL = "2" then BIL_PROV_NAM_LAST |
Externally Adjudicated Pharmacy Claim Load
| BillingProviderName |
"*Not Applicable" |
Payer System Medical Claim Load
| BillingProviderName |
|
||||
Received Claim Load
| BillingProviderName |
|
||||
|
If BIL_PROV_TYP_QUAL = "2" then BIL_PROV_NAM_LAST |
Received Pharmacy Claim Load
| BillingProviderName |
"*Not Applicable" |
BillingProviderLastName
: stringLast name of the billing provider as received on the claim. When the billing provider is a facility or organization, this column may contain the facility/organization name.
Properties
- Data type
- string
- SQL Server data type
- nvarchar(100)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| BillingProviderLastName |
CMS ACO Part B DME File Load
| BillingProviderLastName |
CMS ACO Part B Physicians File Load
| BillingProviderLastName |
CMS ACO Part D Prescription Drug File Load
| BillingProviderLastName |
CMS CJR DME Claim Load
| BillingProviderLastName |
CMS CJR Home Health Claim Load
| BillingProviderLastName |
CMS CJR Hospice Claim Load
| BillingProviderLastName |
CMS CJR Inpatient Claim Load
| BillingProviderLastName |
CMS CJR Outpatient Claim Load
| BillingProviderLastName |
CMS CJR Part B Claim Load
| BillingProviderLastName |
CMS CJR Skilled Nursing Facility Claim Load
| BillingProviderLastName |
Data Aggregation Medical Claim Load
| BillingProviderLastName |
|
||
Externally Adjudicated Medical Claim Load
| BillingProviderLastName |
|
||
Externally Adjudicated Pharmacy Claim Load
| BillingProviderLastName |
Payer System Medical Claim Load
| BillingProviderLastName |
|
||
Received Claim Load
| BillingProviderLastName |
|
||
Received Pharmacy Claim Load
| BillingProviderLastName |
BillingProviderFirstName
: stringFirst name of the billing provider as received on the claim
Properties
- Data type
- string
- SQL Server data type
- nvarchar(50)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| BillingProviderFirstName |
CMS ACO Part B DME File Load
| BillingProviderFirstName |
CMS ACO Part B Physicians File Load
| BillingProviderFirstName |
CMS ACO Part D Prescription Drug File Load
| BillingProviderFirstName |
CMS CJR DME Claim Load
| BillingProviderFirstName |
CMS CJR Home Health Claim Load
| BillingProviderFirstName |
CMS CJR Hospice Claim Load
| BillingProviderFirstName |
CMS CJR Inpatient Claim Load
| BillingProviderFirstName |
CMS CJR Outpatient Claim Load
| BillingProviderFirstName |
CMS CJR Part B Claim Load
| BillingProviderFirstName |
CMS CJR Skilled Nursing Facility Claim Load
| BillingProviderFirstName |
Data Aggregation Medical Claim Load
| BillingProviderFirstName |
|
||
Externally Adjudicated Medical Claim Load
| BillingProviderFirstName |
|
||
Externally Adjudicated Pharmacy Claim Load
| BillingProviderFirstName |
Payer System Medical Claim Load
| BillingProviderFirstName |
|
||
Received Claim Load
| BillingProviderFirstName |
|
||
Received Pharmacy Claim Load
| BillingProviderFirstName |
BillingProviderMiddleName
: stringMiddle name of the billing provider as received on the claim
Properties
- Data type
- string
- SQL Server data type
- nvarchar(50)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| BillingProviderMiddleName |
CMS ACO Part B DME File Load
| BillingProviderMiddleName |
CMS ACO Part B Physicians File Load
| BillingProviderMiddleName |
CMS ACO Part D Prescription Drug File Load
| BillingProviderMiddleName |
CMS CJR DME Claim Load
| BillingProviderMiddleName |
CMS CJR Home Health Claim Load
| BillingProviderMiddleName |
CMS CJR Hospice Claim Load
| BillingProviderMiddleName |
CMS CJR Inpatient Claim Load
| BillingProviderMiddleName |
CMS CJR Outpatient Claim Load
| BillingProviderMiddleName |
CMS CJR Part B Claim Load
| BillingProviderMiddleName |
CMS CJR Skilled Nursing Facility Claim Load
| BillingProviderMiddleName |
Data Aggregation Medical Claim Load
| BillingProviderMiddleName |
|
||
Externally Adjudicated Medical Claim Load
| BillingProviderMiddleName |
|
||
Externally Adjudicated Pharmacy Claim Load
| BillingProviderMiddleName |
Payer System Medical Claim Load
| BillingProviderMiddleName |
|
||
Received Claim Load
| BillingProviderMiddleName |
|
||
Received Pharmacy Claim Load
| BillingProviderMiddleName |
BillingProviderAddress
: stringAddress of the billing provider as received on the claim
Properties
- Data type
- string
- SQL Server data type
- nvarchar(250)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| BillingProviderAddress |
CMS ACO Part B DME File Load
| BillingProviderAddress |
CMS ACO Part B Physicians File Load
| BillingProviderAddress |
CMS ACO Part D Prescription Drug File Load
| BillingProviderAddress |
CMS CJR DME Claim Load
| BillingProviderAddress |
CMS CJR Home Health Claim Load
| BillingProviderAddress |
CMS CJR Hospice Claim Load
| BillingProviderAddress |
CMS CJR Inpatient Claim Load
| BillingProviderAddress |
CMS CJR Outpatient Claim Load
| BillingProviderAddress |
CMS CJR Part B Claim Load
| BillingProviderAddress |
CMS CJR Skilled Nursing Facility Claim Load
| BillingProviderAddress |
Data Aggregation Medical Claim Load
| BillingProviderAddress |
|
||||
|
If BIL_PROV_ADDR_1 is NULL then BIL_PROV_ADDR_2 Otherwise if BIL_PROV_ADDR_2 is NULL then BIL_PROV_ADDR_1 Otherwise BIL_PROV_ADDR_1 + " " + BIL_PROV_ADDR_2 |
Externally Adjudicated Medical Claim Load
| BillingProviderAddress |
|
||||
|
If BIL_PROV_ADDR_1 is NULL then BIL_PROV_ADDR_2 Otherwise if BIL_PROV_ADDR_2 is NULL then BIL_PROV_ADDR_1 Otherwise BIL_PROV_ADDR_1 + " " + BIL_PROV_ADDR_2 |
Externally Adjudicated Pharmacy Claim Load
| BillingProviderAddress |
"*Not Applicable" |
Payer System Medical Claim Load
| BillingProviderAddress |
|
||||
|
If BIL_PROV_ADDR_1 is NULL then BIL_PROV_ADDR_2 Otherwise if BIL_PROV_ADDR_2 is NULL then BIL_PROV_ADDR_1 Otherwise BIL_PROV_ADDR_1 + " " + BIL_PROV_ADDR_2 |
Received Claim Load
| BillingProviderAddress |
|
||||
|
If BIL_PROV_ADDR_1 is NULL then BIL_PROV_ADDR_2 Otherwise if BIL_PROV_ADDR_2 is NULL then BIL_PROV_ADDR_1 Otherwise BIL_PROV_ADDR_1 + " " + BIL_PROV_ADDR_2 |
Received Pharmacy Claim Load
| BillingProviderAddress |
"*Not Applicable" |
BillingProviderCity
: stringCity of the billing provider as received on the claim
Properties
- Data type
- string
- SQL Server data type
- nvarchar(100)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| BillingProviderCity |
CMS ACO Part B DME File Load
| BillingProviderCity |
CMS ACO Part B Physicians File Load
| BillingProviderCity |
CMS ACO Part D Prescription Drug File Load
| BillingProviderCity |
CMS CJR DME Claim Load
| BillingProviderCity |
CMS CJR Home Health Claim Load
| BillingProviderCity |
CMS CJR Hospice Claim Load
| BillingProviderCity |
CMS CJR Inpatient Claim Load
| BillingProviderCity |
CMS CJR Outpatient Claim Load
| BillingProviderCity |
CMS CJR Part B Claim Load
| BillingProviderCity |
CMS CJR Skilled Nursing Facility Claim Load
| BillingProviderCity |
Data Aggregation Medical Claim Load
| BillingProviderCity |
|
||
Externally Adjudicated Medical Claim Load
| BillingProviderCity |
|
||
Externally Adjudicated Pharmacy Claim Load
| BillingProviderCity |
"*Not Applicable" |
Payer System Medical Claim Load
| BillingProviderCity |
|
||
Received Claim Load
| BillingProviderCity |
|
||
Received Pharmacy Claim Load
| BillingProviderCity |
"*Not Applicable" |
BillingProviderStateOrProvince
: stringState or province of the billing provider as received on the claim
Properties
- Data type
- string
- SQL Server data type
- nvarchar(300)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| BillingProviderStateOrProvince |
CMS ACO Part B DME File Load
| BillingProviderStateOrProvince |
CMS ACO Part B Physicians File Load
| BillingProviderStateOrProvince |
CMS ACO Part D Prescription Drug File Load
| BillingProviderStateOrProvince |
CMS CJR DME Claim Load
| BillingProviderStateOrProvince |
CMS CJR Home Health Claim Load
| BillingProviderStateOrProvince |
CMS CJR Hospice Claim Load
| BillingProviderStateOrProvince |
CMS CJR Inpatient Claim Load
| BillingProviderStateOrProvince |
CMS CJR Outpatient Claim Load
| BillingProviderStateOrProvince |
CMS CJR Part B Claim Load
| BillingProviderStateOrProvince |
CMS CJR Skilled Nursing Facility Claim Load
| BillingProviderStateOrProvince |
Data Aggregation Medical Claim Load
| BillingProviderStateOrProvince |
|
||
Externally Adjudicated Medical Claim Load
| BillingProviderStateOrProvince |
|
||
Externally Adjudicated Pharmacy Claim Load
| BillingProviderStateOrProvince |
"*Not Applicable" |
Payer System Medical Claim Load
| BillingProviderStateOrProvince |
|
||
Received Claim Load
| BillingProviderStateOrProvince |
|
||
Received Pharmacy Claim Load
| BillingProviderStateOrProvince |
"*Not Applicable" |
BillingProviderPostalCode
: stringPostal code of the billing provider as received on the claim
Properties
- Data type
- string
- SQL Server data type
- nvarchar(50)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| BillingProviderPostalCode |
CMS ACO Part B DME File Load
| BillingProviderPostalCode |
CMS ACO Part B Physicians File Load
| BillingProviderPostalCode |
CMS ACO Part D Prescription Drug File Load
| BillingProviderPostalCode |
CMS CJR DME Claim Load
| BillingProviderPostalCode |
CMS CJR Home Health Claim Load
| BillingProviderPostalCode |
CMS CJR Hospice Claim Load
| BillingProviderPostalCode |
CMS CJR Inpatient Claim Load
| BillingProviderPostalCode |
CMS CJR Outpatient Claim Load
| BillingProviderPostalCode |
CMS CJR Part B Claim Load
| BillingProviderPostalCode |
CMS CJR Skilled Nursing Facility Claim Load
| BillingProviderPostalCode |
Data Aggregation Medical Claim Load
| BillingProviderPostalCode |
|
||
Externally Adjudicated Medical Claim Load
| BillingProviderPostalCode |
|
||
Externally Adjudicated Pharmacy Claim Load
| BillingProviderPostalCode |
"*Not Applicable" |
Payer System Medical Claim Load
| BillingProviderPostalCode |
|
||
Received Claim Load
| BillingProviderPostalCode |
|
||
Received Pharmacy Claim Load
| BillingProviderPostalCode |
"*Not Applicable" |
BillingProviderCountry
: stringCountry of the billing provider as received on the claim
Properties
- Data type
- string
- SQL Server data type
- nvarchar(300)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| BillingProviderCountry |
CMS ACO Part B DME File Load
| BillingProviderCountry |
CMS ACO Part B Physicians File Load
| BillingProviderCountry |
CMS ACO Part D Prescription Drug File Load
| BillingProviderCountry |
CMS CJR DME Claim Load
| BillingProviderCountry |
CMS CJR Home Health Claim Load
| BillingProviderCountry |
CMS CJR Hospice Claim Load
| BillingProviderCountry |
CMS CJR Inpatient Claim Load
| BillingProviderCountry |
CMS CJR Outpatient Claim Load
| BillingProviderCountry |
CMS CJR Part B Claim Load
| BillingProviderCountry |
CMS CJR Skilled Nursing Facility Claim Load
| BillingProviderCountry |
Data Aggregation Medical Claim Load
| BillingProviderCountry |
|
||
Externally Adjudicated Medical Claim Load
| BillingProviderCountry |
|
||
Externally Adjudicated Pharmacy Claim Load
| BillingProviderCountry |
"*Not Applicable" |
Payer System Medical Claim Load
| BillingProviderCountry |
|
||
Received Claim Load
| BillingProviderCountry |
|
||
Received Pharmacy Claim Load
| BillingProviderCountry |
"*Not Applicable" |
ServiceFacilityNpi
: stringNational Provider Identifier (NPI) of the service facility as received on the claim
Properties
- Data type
- string
- SQL Server data type
- nvarchar(50)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| ServiceFacilityNpi |
CMS ACO Part B DME File Load
| ServiceFacilityNpi |
CMS ACO Part B Physicians File Load
| ServiceFacilityNpi |
CMS ACO Part D Prescription Drug File Load
| ServiceFacilityNpi |
CMS CJR DME Claim Load
| ServiceFacilityNpi |
CMS CJR Home Health Claim Load
| ServiceFacilityNpi |
CMS CJR Hospice Claim Load
| ServiceFacilityNpi |
CMS CJR Inpatient Claim Load
| ServiceFacilityNpi |
CMS CJR Outpatient Claim Load
| ServiceFacilityNpi |
CMS CJR Part B Claim Load
| ServiceFacilityNpi |
CMS CJR Skilled Nursing Facility Claim Load
| ServiceFacilityNpi |
Data Aggregation Medical Claim Load
| ServiceFacilityNpi |
|
||
Externally Adjudicated Medical Claim Load
| ServiceFacilityNpi |
|
||
Externally Adjudicated Pharmacy Claim Load
| ServiceFacilityNpi |
"*Not Applicable" |
Payer System Medical Claim Load
| ServiceFacilityNpi |
|
||
Received Claim Load
| ServiceFacilityNpi |
|
||
Received Pharmacy Claim Load
| ServiceFacilityNpi |
"*Not Applicable" |
ServiceFacilityName
: stringName of the service facility as received on the claim
Properties
- Data type
- string
- SQL Server data type
- nvarchar(100)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| ServiceFacilityName |
CMS ACO Part B DME File Load
| ServiceFacilityName |
CMS ACO Part B Physicians File Load
| ServiceFacilityName |
CMS ACO Part D Prescription Drug File Load
| ServiceFacilityName |
CMS CJR DME Claim Load
| ServiceFacilityName |
CMS CJR Home Health Claim Load
| ServiceFacilityName |
CMS CJR Hospice Claim Load
| ServiceFacilityName |
CMS CJR Inpatient Claim Load
| ServiceFacilityName |
CMS CJR Outpatient Claim Load
| ServiceFacilityName |
CMS CJR Part B Claim Load
| ServiceFacilityName |
CMS CJR Skilled Nursing Facility Claim Load
| ServiceFacilityName |
Data Aggregation Medical Claim Load
| ServiceFacilityName |
|
||
Externally Adjudicated Medical Claim Load
| ServiceFacilityName |
|
||
Externally Adjudicated Pharmacy Claim Load
| ServiceFacilityName |
"*Not Applicable" |
Payer System Medical Claim Load
| ServiceFacilityName |
|
||
Received Claim Load
| ServiceFacilityName |
|
||
Received Pharmacy Claim Load
| ServiceFacilityName |
"*Not Applicable" |
ServiceFacilityPhoneNumber
: stringPhone number of the service facility as received on the claim
Properties
- Data type
- string
- SQL Server data type
- nvarchar(50)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| ServiceFacilityPhoneNumber |
CMS ACO Part B DME File Load
| ServiceFacilityPhoneNumber |
CMS ACO Part B Physicians File Load
| ServiceFacilityPhoneNumber |
CMS ACO Part D Prescription Drug File Load
| ServiceFacilityPhoneNumber |
CMS CJR DME Claim Load
| ServiceFacilityPhoneNumber |
CMS CJR Home Health Claim Load
| ServiceFacilityPhoneNumber |
CMS CJR Hospice Claim Load
| ServiceFacilityPhoneNumber |
CMS CJR Inpatient Claim Load
| ServiceFacilityPhoneNumber |
CMS CJR Outpatient Claim Load
| ServiceFacilityPhoneNumber |
CMS CJR Part B Claim Load
| ServiceFacilityPhoneNumber |
CMS CJR Skilled Nursing Facility Claim Load
| ServiceFacilityPhoneNumber |
Data Aggregation Medical Claim Load
| ServiceFacilityPhoneNumber |
|
||
Externally Adjudicated Medical Claim Load
| ServiceFacilityPhoneNumber |
|
||||
|
If SVC_FAC_CNCT_EXT is NULL then SVC_FAC_CNCT_PH Otherwise SVC_FAC_CNCT_PH + " EXT " + SVC_FAC_CNCT_EXT |
Externally Adjudicated Pharmacy Claim Load
| ServiceFacilityPhoneNumber |
"*Not Applicable" |
Payer System Medical Claim Load
| ServiceFacilityPhoneNumber |
|
||
Received Claim Load
| ServiceFacilityPhoneNumber |
|
||||
|
If SVC_FAC_CNCT_EXT is NULL then SVC_FAC_CNCT_PH Otherwise SVC_FAC_CNCT_PH + " EXT " + SVC_FAC_CNCT_EXT |
Received Pharmacy Claim Load
| ServiceFacilityPhoneNumber |
"*Not Applicable" |
ServiceFacilityAddress
: stringAddress of the service facility as received on the claim
Properties
- Data type
- string
- SQL Server data type
- nvarchar(250)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| ServiceFacilityAddress |
CMS ACO Part B DME File Load
| ServiceFacilityAddress |
CMS ACO Part B Physicians File Load
| ServiceFacilityAddress |
CMS ACO Part D Prescription Drug File Load
| ServiceFacilityAddress |
CMS CJR DME Claim Load
| ServiceFacilityAddress |
CMS CJR Home Health Claim Load
| ServiceFacilityAddress |
CMS CJR Hospice Claim Load
| ServiceFacilityAddress |
CMS CJR Inpatient Claim Load
| ServiceFacilityAddress |
CMS CJR Outpatient Claim Load
| ServiceFacilityAddress |
CMS CJR Part B Claim Load
| ServiceFacilityAddress |
CMS CJR Skilled Nursing Facility Claim Load
| ServiceFacilityAddress |
Data Aggregation Medical Claim Load
| ServiceFacilityAddress |
|
||||
|
If SVC_FAC_ADDR_1 is NULL then SVC_FAC_ADDR_2 Otherwise if SVC_FAC_ADDR_2 is NULL then SVC_FAC_ADDR_1 Otherwise SVC_FAC_ADDR_1 + " " + SVC_FAC_ADDR_2 |
Externally Adjudicated Medical Claim Load
| ServiceFacilityAddress |
|
||||
|
If SVC_FAC_ADDR_1 is NULL then SVC_FAC_ADDR_2 Otherwise if SVC_FAC_ADDR_2 is NULL then SVC_FAC_ADDR_1 Otherwise SVC_FAC_ADDR_1 + " " + SVC_FAC_ADDR_2 |
Externally Adjudicated Pharmacy Claim Load
| ServiceFacilityAddress |
"*Not Applicable" |
Payer System Medical Claim Load
| ServiceFacilityAddress |
|
||||
|
If SVC_FAC_ADDR_1 is NULL then SVC_FAC_ADDR_2 Otherwise if SVC_FAC_ADDR_2 is NULL then SVC_FAC_ADDR_1 Otherwise SVC_FAC_ADDR_1 + " " + SVC_FAC_ADDR_2 |
Received Claim Load
| ServiceFacilityAddress |
|
||||
|
If SVC_FAC_ADDR_1 is NULL then SVC_FAC_ADDR_2 Otherwise if SVC_FAC_ADDR_2 is NULL then SVC_FAC_ADDR_1 Otherwise SVC_FAC_ADDR_1 + " " + SVC_FAC_ADDR_2 |
Received Pharmacy Claim Load
| ServiceFacilityAddress |
"*Not Applicable" |
ServiceFacilityCity
: stringCity of the service facility as received on the claim
Properties
- Data type
- string
- SQL Server data type
- nvarchar(100)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| ServiceFacilityCity |
CMS ACO Part B DME File Load
| ServiceFacilityCity |
CMS ACO Part B Physicians File Load
| ServiceFacilityCity |
CMS ACO Part D Prescription Drug File Load
| ServiceFacilityCity |
CMS CJR DME Claim Load
| ServiceFacilityCity |
CMS CJR Home Health Claim Load
| ServiceFacilityCity |
CMS CJR Hospice Claim Load
| ServiceFacilityCity |
CMS CJR Inpatient Claim Load
| ServiceFacilityCity |
CMS CJR Outpatient Claim Load
| ServiceFacilityCity |
CMS CJR Part B Claim Load
| ServiceFacilityCity |
CMS CJR Skilled Nursing Facility Claim Load
| ServiceFacilityCity |
Data Aggregation Medical Claim Load
| ServiceFacilityCity |
|
||
Externally Adjudicated Medical Claim Load
| ServiceFacilityCity |
|
||
Externally Adjudicated Pharmacy Claim Load
| ServiceFacilityCity |
"*Not Applicable" |
Payer System Medical Claim Load
| ServiceFacilityCity |
|
||
Received Claim Load
| ServiceFacilityCity |
|
||
Received Pharmacy Claim Load
| ServiceFacilityCity |
"*Not Applicable" |
ServiceFacilityStateOrProvince
: stringState or province of the service facility as received on the claim
Properties
- Data type
- string
- SQL Server data type
- nvarchar(300)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| ServiceFacilityStateOrProvince |
CMS ACO Part B DME File Load
| ServiceFacilityStateOrProvince |
CMS ACO Part B Physicians File Load
| ServiceFacilityStateOrProvince |
CMS ACO Part D Prescription Drug File Load
| ServiceFacilityStateOrProvince |
CMS CJR DME Claim Load
| ServiceFacilityStateOrProvince |
CMS CJR Home Health Claim Load
| ServiceFacilityStateOrProvince |
CMS CJR Hospice Claim Load
| ServiceFacilityStateOrProvince |
CMS CJR Inpatient Claim Load
| ServiceFacilityStateOrProvince |
CMS CJR Outpatient Claim Load
| ServiceFacilityStateOrProvince |
CMS CJR Part B Claim Load
| ServiceFacilityStateOrProvince |
CMS CJR Skilled Nursing Facility Claim Load
| ServiceFacilityStateOrProvince |
Data Aggregation Medical Claim Load
| ServiceFacilityStateOrProvince |
|
||
Externally Adjudicated Medical Claim Load
| ServiceFacilityStateOrProvince |
|
||
Externally Adjudicated Pharmacy Claim Load
| ServiceFacilityStateOrProvince |
"*Not Applicable" |
Payer System Medical Claim Load
| ServiceFacilityStateOrProvince |
|
||
Received Claim Load
| ServiceFacilityStateOrProvince |
|
||
Received Pharmacy Claim Load
| ServiceFacilityStateOrProvince |
"*Not Applicable" |
ServiceFacilityPostalCode
: stringPostal code of the service facility as received on the claim
Properties
- Data type
- string
- SQL Server data type
- nvarchar(50)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| ServiceFacilityPostalCode |
CMS ACO Part B DME File Load
| ServiceFacilityPostalCode |
CMS ACO Part B Physicians File Load
| ServiceFacilityPostalCode |
CMS ACO Part D Prescription Drug File Load
| ServiceFacilityPostalCode |
CMS CJR DME Claim Load
| ServiceFacilityPostalCode |
CMS CJR Home Health Claim Load
| ServiceFacilityPostalCode |
CMS CJR Hospice Claim Load
| ServiceFacilityPostalCode |
CMS CJR Inpatient Claim Load
| ServiceFacilityPostalCode |
CMS CJR Outpatient Claim Load
| ServiceFacilityPostalCode |
CMS CJR Part B Claim Load
| ServiceFacilityPostalCode |
CMS CJR Skilled Nursing Facility Claim Load
| ServiceFacilityPostalCode |
Data Aggregation Medical Claim Load
| ServiceFacilityPostalCode |
|
||
Externally Adjudicated Medical Claim Load
| ServiceFacilityPostalCode |
|
||
Externally Adjudicated Pharmacy Claim Load
| ServiceFacilityPostalCode |
"*Not Applicable" |
Payer System Medical Claim Load
| ServiceFacilityPostalCode |
|
||
Received Claim Load
| ServiceFacilityPostalCode |
|
||
Received Pharmacy Claim Load
| ServiceFacilityPostalCode |
"*Not Applicable" |
ServiceFacilityCountry
: stringCountry of the service facility as received on the claim
Properties
- Data type
- string
- SQL Server data type
- nvarchar(300)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| ServiceFacilityCountry |
CMS ACO Part B DME File Load
| ServiceFacilityCountry |
CMS ACO Part B Physicians File Load
| ServiceFacilityCountry |
CMS ACO Part D Prescription Drug File Load
| ServiceFacilityCountry |
CMS CJR DME Claim Load
| ServiceFacilityCountry |
CMS CJR Home Health Claim Load
| ServiceFacilityCountry |
CMS CJR Hospice Claim Load
| ServiceFacilityCountry |
CMS CJR Inpatient Claim Load
| ServiceFacilityCountry |
CMS CJR Outpatient Claim Load
| ServiceFacilityCountry |
CMS CJR Part B Claim Load
| ServiceFacilityCountry |
CMS CJR Skilled Nursing Facility Claim Load
| ServiceFacilityCountry |
Data Aggregation Medical Claim Load
| ServiceFacilityCountry |
|
||
Externally Adjudicated Medical Claim Load
| ServiceFacilityCountry |
|
||
Externally Adjudicated Pharmacy Claim Load
| ServiceFacilityCountry |
"*Not Applicable" |
Payer System Medical Claim Load
| ServiceFacilityCountry |
|
||
Received Claim Load
| ServiceFacilityCountry |
|
||
Received Pharmacy Claim Load
| ServiceFacilityCountry |
"*Not Applicable" |
ServiceClassContext
: stringThe context of the service classification for this claim, based on the Claim Service Classification Mapping Table in your system definitions. Only contains data if you use the Chronicles Claims Loader.
Properties
- Data type
- string
- SQL Server data type
- nvarchar(300)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| ServiceClassContext |
*Not Applicable |
CMS ACO Part B DME File Load
| ServiceClassContext |
*Not Applicable |
CMS ACO Part B Physicians File Load
| ServiceClassContext |
*Not Applicable |
CMS ACO Part D Prescription Drug File Load
| ServiceClassContext |
*Not Applicable |
CMS CJR DME Claim Load
| ServiceClassContext |
*Not Applicable |
CMS CJR Home Health Claim Load
| ServiceClassContext |
*Not Applicable |
CMS CJR Hospice Claim Load
| ServiceClassContext |
*Not Applicable |
CMS CJR Inpatient Claim Load
| ServiceClassContext |
*Not Applicable |
CMS CJR Outpatient Claim Load
| ServiceClassContext |
*Not Applicable |
CMS CJR Part B Claim Load
| ServiceClassContext |
*Not Applicable |
CMS CJR Skilled Nursing Facility Claim Load
| ServiceClassContext |
*Not Applicable |
Data Aggregation Medical Claim Load
| ServiceClassContext |
|
||||||
Data Aggregation Pharmacy Claim Load
| ServiceClassContext |
|
||||||
|
The context of the service classification for this claim, based on the Claim Service Classification Mapping Table in your system definitions. Only contains data if you use the Chronicles Claims Loader. |
Externally Adjudicated Medical Claim Load
| ServiceClassContext |
|
||||||
Externally Adjudicated Pharmacy Claim Load
| ServiceClassContext |
|
||||||
|
The context of the service classification for this claim, based on the Claim Service Classification Mapping Table in your system definitions. Only contains data if you use the Chronicles Claims Loader. |
Payer System Medical Claim Load
| ServiceClassContext |
|
||||||
Payer System Pharmacy Claim Load
| ServiceClassContext |
|
||||||
|
The context of the service classification for this claim, based on the Claim Service Classification Mapping Table in your system definitions. Only contains data if you use the Chronicles Claims Loader. |
Received Claim Load
| ServiceClassContext |
|
||||||
|
If AP_CLAIM_3.CLAIM_SVC_CLASS_CTX_C is NULL then "*Unspecified" Otherwise if ZC_CLAIM_SVC_CLASS_CTX.CLAIM_SVC_CLASS_CTX_C is NULL then "*Unknown" Otherwise ZC_CLAIM_SVC_CLASS_CTX.NAME |
Received Pharmacy Claim Load
| ServiceClassContext |
|
||||||
|
The context of the service classification for this claim, based on the Claim Service Classification Mapping Table in your system definitions. Only contains data if you use the Chronicles Claims Loader. |
ServiceClass
: stringThe service classification for this claim, based on the Claim Service Classification Mapping Table in your system definitions. Only contains data if you use the Chronicles Claims Loader.
Properties
- Data type
- string
- SQL Server data type
- nvarchar(300)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| ServiceClass |
*Not Applicable |
CMS ACO Part B DME File Load
| ServiceClass |
*Not Applicable |
CMS ACO Part B Physicians File Load
| ServiceClass |
*Not Applicable |
CMS ACO Part D Prescription Drug File Load
| ServiceClass |
*Not Applicable |
CMS CJR DME Claim Load
| ServiceClass |
*Not Applicable |
CMS CJR Home Health Claim Load
| ServiceClass |
*Not Applicable |
CMS CJR Hospice Claim Load
| ServiceClass |
*Not Applicable |
CMS CJR Inpatient Claim Load
| ServiceClass |
*Not Applicable |
CMS CJR Outpatient Claim Load
| ServiceClass |
*Not Applicable |
CMS CJR Part B Claim Load
| ServiceClass |
*Not Applicable |
CMS CJR Skilled Nursing Facility Claim Load
| ServiceClass |
*Not Applicable |
Data Aggregation Medical Claim Load
| ServiceClass |
|
||||||
Data Aggregation Pharmacy Claim Load
| ServiceClass |
|
||||||
|
The service classification for this claim, based on the Claim Service Classification Mapping Table in your system definitions. Only contains data if you use the Chronicles Claims Loader. |
Externally Adjudicated Medical Claim Load
| ServiceClass |
|
||||||
Externally Adjudicated Pharmacy Claim Load
| ServiceClass |
|
||||||
|
The service classification for this claim, based on the Claim Service Classification Mapping Table in your system definitions. Only contains data if you use the Chronicles Claims Loader. |
Payer System Medical Claim Load
| ServiceClass |
|
||||||
Payer System Pharmacy Claim Load
| ServiceClass |
|
||||||
|
The service classification for this claim, based on the Claim Service Classification Mapping Table in your system definitions. Only contains data if you use the Chronicles Claims Loader. |
Received Claim Load
| ServiceClass |
|
||||||
|
If AP_CLAIM_3.CLAIM_SVC_CLASS_C is NULL then "*Unspecified" Otherwise if ZC_CLAIM_SVC_CLASS.CLAIM_SVC_CLASS_C is NULL then "*Unknown" Otherwise ZC_CLAIM_SVC_CLASS.NAME |
Received Pharmacy Claim Load
| ServiceClass |
|
||||||
|
The service classification for this claim, based on the Claim Service Classification Mapping Table in your system definitions. Only contains data if you use the Chronicles Claims Loader. |
ClaimEpicId
: numberEpic ID of the claim. This column identifies claim (CLM) records.
Properties
- Data type
- number
- SQL Server data type
- numeric(18,0)
- Allows null
- Yes
Data Lineage for Each Package
CMS ACO Part A Files Load
| ClaimEpicId |
NULL |
CMS ACO Part B DME File Load
| ClaimEpicId |
NULL |
CMS ACO Part B Physicians File Load
| ClaimEpicId |
NULL |
CMS ACO Part D Prescription Drug File Load
| ClaimEpicId |
NULL |
CMS CJR DME Claim Load
| ClaimEpicId |
NULL |
CMS CJR Home Health Claim Load
| ClaimEpicId |
NULL |
CMS CJR Hospice Claim Load
| ClaimEpicId |
NULL |
CMS CJR Inpatient Claim Load
| ClaimEpicId |
NULL |
CMS CJR Outpatient Claim Load
| ClaimEpicId |
NULL |
CMS CJR Part B Claim Load
| ClaimEpicId |
NULL |
CMS CJR Skilled Nursing Facility Claim Load
| ClaimEpicId |
NULL |
Data Aggregation Medical Claim Load
| ClaimEpicId |
|
||
Data Aggregation Pharmacy Claim Load
| ClaimEpicId |
|
||
Externally Adjudicated Medical Claim Load
| ClaimEpicId |
|
||
Externally Adjudicated Pharmacy Claim Load
| ClaimEpicId |
|
||
Payer System Medical Claim Load
| ClaimEpicId |
|
||
Payer System Pharmacy Claim Load
| ClaimEpicId |
|
||
Received Claim Load
| ClaimEpicId |
|
||
Received Pharmacy Claim Load
| ClaimEpicId |
|
||
ClaimSpecialty
: stringSpecialty associated with the claim
Properties
- Data type
- string
- SQL Server data type
- nvarchar(300)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| ClaimSpecialty |
"*Not Applicable" |
CMS ACO Part B DME File Load
| ClaimSpecialty |
"*Not Applicable" |
CMS ACO Part B Physicians File Load
| ClaimSpecialty |
"*Not Applicable" |
CMS ACO Part D Prescription Drug File Load
| ClaimSpecialty |
"*Not Applicable" |
CMS CJR DME Claim Load
| ClaimSpecialty |
NULL |
CMS CJR Home Health Claim Load
| ClaimSpecialty |
NULL |
CMS CJR Hospice Claim Load
| ClaimSpecialty |
NULL |
CMS CJR Inpatient Claim Load
| ClaimSpecialty |
NULL |
CMS CJR Outpatient Claim Load
| ClaimSpecialty |
NULL |
CMS CJR Part B Claim Load
| ClaimSpecialty |
NULL |
CMS CJR Skilled Nursing Facility Claim Load
| ClaimSpecialty |
NULL |
Data Aggregation Pharmacy Claim Load
| ClaimSpecialty |
"*Unspecified" |
Externally Adjudicated Medical Claim Load
| ClaimSpecialty |
"*Unspecified" |
Externally Adjudicated Pharmacy Claim Load
| ClaimSpecialty |
"*Unspecified" |
Payer System Pharmacy Claim Load
| ClaimSpecialty |
"*Unspecified" |
Received Claim Load
| ClaimSpecialty |
|
||||||
|
If AP_CLAIM.ASSOC_SPEC_C is NULL then "*Unspecified" Otherwise if ZC_SPECIALTY.SPECIALTY_C is NULL then "*Unknown" Otherwise ZC_SPECIALTY.NAME |
Received Pharmacy Claim Load
| ClaimSpecialty |
"*Unspecified" |
DaysCleanDeniedLate
: integerIf the adjudication date in CleanDeniedDateKey is after the due date in PaymentDueDateKey, this column stores the difference in days
Properties
- Data type
- integer
- SQL Server data type
- int
- Allows null
- Yes
Data Lineage for Each Package
CMS ACO Part A Files Load
| DaysCleanDeniedLate |
NULL |
CMS ACO Part B DME File Load
| DaysCleanDeniedLate |
NULL |
CMS ACO Part B Physicians File Load
| DaysCleanDeniedLate |
NULL |
CMS ACO Part D Prescription Drug File Load
| DaysCleanDeniedLate |
NULL |
CMS CJR DME Claim Load
| DaysCleanDeniedLate |
NULL |
CMS CJR Home Health Claim Load
| DaysCleanDeniedLate |
NULL |
CMS CJR Hospice Claim Load
| DaysCleanDeniedLate |
NULL |
CMS CJR Inpatient Claim Load
| DaysCleanDeniedLate |
NULL |
CMS CJR Outpatient Claim Load
| DaysCleanDeniedLate |
NULL |
CMS CJR Part B Claim Load
| DaysCleanDeniedLate |
NULL |
CMS CJR Skilled Nursing Facility Claim Load
| DaysCleanDeniedLate |
NULL |
Received Claim Load
| DaysCleanDeniedLate |
|
||||||||
|
If AP_CLAIM.STATUS_C is 3 or 4 and AP_CLAIM.STATUS_DATE > PaymentDueDate then AP_CLAIM.STATUS_DATE - PaymentDueDate |
DaysPaidLate
: integerIf the paid date in PaidDateKey is after the due date in PaymentDueDateKey, this column stores the difference in days
Properties
- Data type
- integer
- SQL Server data type
- int
- Allows null
- Yes
Data Lineage for Each Package
CMS ACO Part A Files Load
| DaysPaidLate |
NULL |
CMS ACO Part B DME File Load
| DaysPaidLate |
NULL |
CMS ACO Part B Physicians File Load
| DaysPaidLate |
NULL |
CMS ACO Part D Prescription Drug File Load
| DaysPaidLate |
NULL |
CMS CJR DME Claim Load
| DaysPaidLate |
NULL |
CMS CJR Home Health Claim Load
| DaysPaidLate |
NULL |
CMS CJR Hospice Claim Load
| DaysPaidLate |
NULL |
CMS CJR Inpatient Claim Load
| DaysPaidLate |
NULL |
CMS CJR Outpatient Claim Load
| DaysPaidLate |
NULL |
CMS CJR Part B Claim Load
| DaysPaidLate |
NULL |
CMS CJR Skilled Nursing Facility Claim Load
| DaysPaidLate |
NULL |
Received Claim Load
| DaysPaidLate |
|
||||||||
|
If AP_CHECK.POST_DATE > PaymentDueDate then AP_CHECK.POST_DATE - PaymentDueDate |
DaysToPay
: integerNumber of days after receiving the claim that the claim was paid
Properties
- Data type
- integer
- SQL Server data type
- int
- Allows null
- Yes
Data Lineage for Each Package
CMS ACO Part A Files Load
| DaysToPay |
NULL |
CMS ACO Part B DME File Load
| DaysToPay |
NULL |
CMS ACO Part B Physicians File Load
| DaysToPay |
NULL |
CMS ACO Part D Prescription Drug File Load
| DaysToPay |
NULL |
CMS CJR DME Claim Load
| DaysToPay |
NULL |
CMS CJR Home Health Claim Load
| DaysToPay |
NULL |
CMS CJR Hospice Claim Load
| DaysToPay |
NULL |
CMS CJR Inpatient Claim Load
| DaysToPay |
NULL |
CMS CJR Outpatient Claim Load
| DaysToPay |
NULL |
CMS CJR Part B Claim Load
| DaysToPay |
NULL |
CMS CJR Skilled Nursing Facility Claim Load
| DaysToPay |
NULL |
Received Claim Load
| DaysToPay |
|
||||
|
If POST_DATE is not NULL then POST_DATE - DATE_RECEIVED Otherwise NULL |
EntryMethod
: stringThe method used to enter the claim. For Epic data, possible values are "EDI", "OCR", "Manual", or "Chronicles Claims Loader".
Properties
- Data type
- string
- SQL Server data type
- nvarchar(50)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| EntryMethod |
"*Not Applicable" |
CMS ACO Part B DME File Load
| EntryMethod |
"*Not Applicable" |
CMS ACO Part B Physicians File Load
| EntryMethod |
"*Not Applicable" |
CMS ACO Part D Prescription Drug File Load
| EntryMethod |
"*Not Applicable" |
CMS CJR DME Claim Load
| EntryMethod |
NULL |
CMS CJR Home Health Claim Load
| EntryMethod |
NULL |
CMS CJR Hospice Claim Load
| EntryMethod |
NULL |
CMS CJR Inpatient Claim Load
| EntryMethod |
NULL |
CMS CJR Outpatient Claim Load
| EntryMethod |
NULL |
CMS CJR Part B Claim Load
| EntryMethod |
NULL |
CMS CJR Skilled Nursing Facility Claim Load
| EntryMethod |
NULL |
Data Aggregation Medical Claim Load
| EntryMethod |
|
||||
|
"Chronicles Claims Loader" |
Data Aggregation Pharmacy Claim Load
| EntryMethod |
"Chronicles Claims Loader" |
Externally Adjudicated Medical Claim Load
| EntryMethod |
|
||||
|
"EDI" |
Externally Adjudicated Pharmacy Claim Load
| EntryMethod |
|
||
|
If WORKFLOW_C IN ( 4, 5, 8 ) then "EDI" Otherwise "Manual" |
Payer System Medical Claim Load
| EntryMethod |
|
||||
|
"Chronicles Claims Loader" |
Payer System Pharmacy Claim Load
| EntryMethod |
"Chronicles Claims Loader" |
Received Claim Load
| EntryMethod |
|
||||||
|
If AP_CLAIM.WORKFLOW_C = 8 then "EDI" Otherwise if AP_CLAIM.EDI_INFO is not NULL then "EDI" Otherwise if AP_CLAIM_2.FROM_OCR_YN = Y then "OCR" Otherwise if AP_CLAIM.WORKFLOW_C IN ( 4, 5 ) then "EDI" Otherwise "Manual" |
Received Pharmacy Claim Load
| EntryMethod |
|
||
|
If WORKFLOW_C IN ( 4, 5, 8 ) then "EDI" Otherwise "Manual" |
LineOfBusinessName
: stringName of the line of business associated with the claim
Properties
- Data type
- string
- SQL Server data type
- nvarchar(100)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| LineOfBusinessName |
"*Not Applicable" |
CMS ACO Part B DME File Load
| LineOfBusinessName |
"*Not Applicable" |
CMS ACO Part B Physicians File Load
| LineOfBusinessName |
"*Not Applicable" |
CMS ACO Part D Prescription Drug File Load
| LineOfBusinessName |
"*Not Applicable" |
CMS CJR DME Claim Load
| LineOfBusinessName |
NULL |
CMS CJR Home Health Claim Load
| LineOfBusinessName |
NULL |
CMS CJR Hospice Claim Load
| LineOfBusinessName |
NULL |
CMS CJR Inpatient Claim Load
| LineOfBusinessName |
NULL |
CMS CJR Outpatient Claim Load
| LineOfBusinessName |
NULL |
CMS CJR Part B Claim Load
| LineOfBusinessName |
NULL |
CMS CJR Skilled Nursing Facility Claim Load
| LineOfBusinessName |
NULL |
Data Aggregation Medical Claim Load
| LineOfBusinessName |
|
||
Data Aggregation Pharmacy Claim Load
| LineOfBusinessName |
|
||
Externally Adjudicated Medical Claim Load
| LineOfBusinessName |
|
||||
|
If CLARITY_LOB.LOB_NAME is not NULL then CLARITY_LOB.LOB_NAME Otherwise if AP_CLAIM.CLM_LOB_ID is NULL then "*Unspecified" Otherwise "*Unknown" |
Externally Adjudicated Pharmacy Claim Load
| LineOfBusinessName |
"*Unspecified" |
Payer System Medical Claim Load
| LineOfBusinessName |
|
||
Payer System Pharmacy Claim Load
| LineOfBusinessName |
|
||
Received Claim Load
| LineOfBusinessName |
|
||||
|
If LOB_NAME is not NULL then LOB_NAME Otherwise if CLM_LOB_ID is NULL then "*Unspecified" Otherwise "*Unknown" |
Received Pharmacy Claim Load
| LineOfBusinessName |
"*Unspecified" |
LineOfBusinessEpicId
: stringEpic Id of the line of business associated with the claim
Properties
- Data type
- string
- SQL Server data type
- nvarchar(50)
- Allows null
- No
- Default value
- empty string
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| LineOfBusinessEpicId |
|
||
|
Line of business as configured through interface configuration in Chronicles |
CMS ACO Part B DME File Load
| LineOfBusinessEpicId |
|
||
|
Line of business as configured through interface configuration in Chronicles |
CMS ACO Part B Physicians File Load
| LineOfBusinessEpicId |
|
||
|
Line of business as configured through interface configuration in Chronicles |
CMS ACO Part D Prescription Drug File Load
| LineOfBusinessEpicId |
|
||
|
Line of business as configured through interface configuration in Chronicles |
CMS CJR DME Claim Load
| LineOfBusinessEpicId |
NULL |
CMS CJR Home Health Claim Load
| LineOfBusinessEpicId |
NULL |
CMS CJR Hospice Claim Load
| LineOfBusinessEpicId |
NULL |
CMS CJR Inpatient Claim Load
| LineOfBusinessEpicId |
NULL |
CMS CJR Outpatient Claim Load
| LineOfBusinessEpicId |
NULL |
CMS CJR Part B Claim Load
| LineOfBusinessEpicId |
NULL |
CMS CJR Skilled Nursing Facility Claim Load
| LineOfBusinessEpicId |
NULL |
Data Aggregation Medical Claim Load
| LineOfBusinessEpicId |
|
||
Data Aggregation Pharmacy Claim Load
| LineOfBusinessEpicId |
|
||
Externally Adjudicated Medical Claim Load
| LineOfBusinessEpicId |
|
||
Externally Adjudicated Pharmacy Claim Load
| LineOfBusinessEpicId |
"*Unspecified" |
Payer System Medical Claim Load
| LineOfBusinessEpicId |
|
||
Payer System Pharmacy Claim Load
| LineOfBusinessEpicId |
|
||
Received Claim Load
| LineOfBusinessEpicId |
|
||
Received Pharmacy Claim Load
| LineOfBusinessEpicId |
"*Unspecified" |
NetworkLevel
: stringIn/Out of network indicator for the claim, or the in-network level assigned to the claim
Properties
- Data type
- string
- SQL Server data type
- nvarchar(300)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| NetworkLevel |
"*Not Applicable" |
CMS ACO Part B DME File Load
| NetworkLevel |
"*Not Applicable" |
CMS ACO Part B Physicians File Load
| NetworkLevel |
"*Not Applicable" |
CMS ACO Part D Prescription Drug File Load
| NetworkLevel |
"*Not Applicable" |
CMS CJR DME Claim Load
| NetworkLevel |
NULL |
CMS CJR Home Health Claim Load
| NetworkLevel |
NULL |
CMS CJR Hospice Claim Load
| NetworkLevel |
NULL |
CMS CJR Inpatient Claim Load
| NetworkLevel |
NULL |
CMS CJR Outpatient Claim Load
| NetworkLevel |
NULL |
CMS CJR Part B Claim Load
| NetworkLevel |
NULL |
CMS CJR Skilled Nursing Facility Claim Load
| NetworkLevel |
NULL |
Data Aggregation Medical Claim Load
| NetworkLevel |
|
||||||
|
If AP_CLAIM.IN_OUT_NET_C is NULL then "*Unspecified" Otherwise if ZC_ADJ_NET_STATUS.ADJ_NET_STATUS_C is NULL then "*Unknown" Otherwise ZC_ADJ_NET_STATUS.NAME |
Data Aggregation Pharmacy Claim Load
| NetworkLevel |
|
||||||
|
If AP_CLM_RX_2.IN_OUT_OF_NET_C is NULL THEN "*Unspecified" Otherwise if ZC_ADJ_NET_STATUS.ADJ_NET_STATUS_C is NULL THEN "*Unknown" Otherwise ZC_ADJ_NET_STATUS.NAME |
Externally Adjudicated Medical Claim Load
| NetworkLevel |
|
||||||
|
If AP_CLAIM.IN_OUT_NET_C is NULL then ''*Unspecified''' Otherwise if ZC_ADJ_NET_STATUS.ADJ_NET_STATUS_C is NULL then ''*Unknown''' Otherwise if ZC_NET_AFFIL_LEVEL.NAME IS NOT NULL THEN ZC_NET_AFFIL_LEVEL.NAME Otherwise ZC_ADJ_NET_STATUS.NAME |
Externally Adjudicated Pharmacy Claim Load
| NetworkLevel |
|
||||||
|
If AP_CLM_RX_2.IN_OUT_OF_NET_C is NULL then '*Unspecified' Otherwise if ZC_ADJ_NET_STATUS.ADJ_NET_STATUS_C is NULL then '*Unknown' Otherwise ZC_ADJ_NET_STATUS.NAME |
Payer System Medical Claim Load
| NetworkLevel |
|
||||||
|
If AP_CLAIM.IN_OUT_NET_C is NULL then "*Unspecified" Otherwise if ZC_ADJ_NET_STATUS.ADJ_NET_STATUS_C is NULL then "*Unknown" Otherwise ZC_ADJ_NET_STATUS.NAME |
Payer System Pharmacy Claim Load
| NetworkLevel |
|
||||||
|
If AP_CLM_RX_2.IN_OUT_OF_NET_C is NULL THEN "*Unspecified" Otherwise if ZC_ADJ_NET_STATUS.ADJ_NET_STATUS_C is NULL THEN "*Unknown" Otherwise ZC_ADJ_NET_STATUS.NAME |
Received Claim Load
| NetworkLevel |
|
||||||||||||||||
|
If OVERALL_NETWORK_LEVEL is not NULL then OVERALL_NETWORK_LEVEL Otherwise if OUT_NET_ADJUD_OV_C is not NULL and ZC_ADJ_NET_STATUS.NAME is null where ZC_ADJ_NET_STATUS.ADJ_NET_STATUS_C = 2 - Out of Network THEN "*Unknown" Otherwise if OUT_NET_ADJUD_OV_C is not NULL then ZC_ADJ_NET_STATUS.NAME where ZC_ADJ_NET_STATUS.ADJ_NET_STATUS_C = 2 - Out of Network Otherwise if AP_CLAIM.IN_OUT_NET_C is NULL then "*Unspecified" Otherwise if ZC_ADJ_NET_STATUS.ADJ_NET_STATUS_C is NULL then "*Unknown" Otherwise if ZC_NET_AFFIL_LEVEL.NAME is not NULL then ZC_NET_AFFIL_LEVEL.NAME Otherwise ZC_ADJ_NET_STATUS.NAME |
Received Pharmacy Claim Load
| NetworkLevel |
"*Unspecified" |
ProcessingStatus
: stringStatus to which the claim has been processed, such as pending or denied
Properties
- Data type
- string
- SQL Server data type
- nvarchar(300)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| ProcessingStatus |
|
||||||||
|
If CLM_MDCR_NPMT_RSN_CD is NULL then "*Unspecified" Otherwise if Id is NULL where CategoryName = "ClaimMedicareNonPaymentReasonCode" then "*Unspecified" Otherwise if IsDenial = 1 then "Denied" Otherwise "Clean" |
CMS ACO Part B DME File Load
| ProcessingStatus |
|
||||||||
|
If CLM_CARR_PMT_DNL_CD is NULL then "*Unspecified" Otherwise if Id is NULL where CategoryName = "ClaimCarrierPaymentDenialCode" then "*Unspecified" Otherwise if IsDenial = 1 then "Denied" Otherwise "Clean" |
CMS ACO Part B Physicians File Load
| ProcessingStatus |
|
||||||||
|
If CLM_CARR_PMT_DNL_CD is NULL then "*Unspecified" Otherwise if Id is NULL where CategoryName = "ClaimCarrierPaymentDenialCode" then "*Unspecified" Otherwise if IsDenial = 1 then "Denied" Otherwise "Clean" |
CMS ACO Part D Prescription Drug File Load
| ProcessingStatus |
"*Not Applicable" |
CMS CJR DME Claim Load
| ProcessingStatus |
NULL |
CMS CJR Home Health Claim Load
| ProcessingStatus |
NULL |
CMS CJR Hospice Claim Load
| ProcessingStatus |
NULL |
CMS CJR Inpatient Claim Load
| ProcessingStatus |
NULL |
CMS CJR Outpatient Claim Load
| ProcessingStatus |
NULL |
CMS CJR Part B Claim Load
| ProcessingStatus |
NULL |
CMS CJR Skilled Nursing Facility Claim Load
| ProcessingStatus |
NULL |
Data Aggregation Medical Claim Load
| ProcessingStatus |
|
||||||
|
If AP_CLAIM.STATUS_C is NULL then "*Unspecified" Otherwise if ZC_CLM_STATUS.STATUS_C is NULL then "*Unknown" Otherwise ZC_CLM_STATUS.NAME |
Data Aggregation Pharmacy Claim Load
| ProcessingStatus |
|
||||||
Externally Adjudicated Medical Claim Load
| ProcessingStatus |
|
||||||
|
If AP_CLAIM.STATUS_C is NULL then "*Unspecified" Otherwise if ZC_CLM_STATUS.STATUS_C is NULL then "*Unknown" Otherwise ZC_CLM_STATUS.NAME |
Externally Adjudicated Pharmacy Claim Load
| ProcessingStatus |
|
||||||
Payer System Medical Claim Load
| ProcessingStatus |
|
||||||
|
If AP_CLAIM.STATUS_C is NULL then "*Unspecified" Otherwise if ZC_CLM_STATUS.STATUS_C is NULL then "*Unknown" Otherwise ZC_CLM_STATUS.NAME |
Payer System Pharmacy Claim Load
| ProcessingStatus |
|
||||||
Received Claim Load
| ProcessingStatus |
|
||||||
|
If AP_CLAIM.STATUS_C is NULL then "*Unspecified" Otherwise if ZC_CLM_STATUS.STATUS_C is NULL then "*Unknown" Otherwise ZC_CLM_STATUS.NAME |
Received Pharmacy Claim Load
| ProcessingStatus |
|
||||||
PaymentStatus
: stringStatus the claim has reached in the payment stage of the process. For Epic data, possible values include "Released to Accounts Payable", "Batched for Payment", and "EOB Generated".
Properties
- Data type
- string
- SQL Server data type
- nvarchar(300)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| PaymentStatus |
"*Not Applicable" |
CMS ACO Part B DME File Load
| PaymentStatus |
"*Not Applicable" |
CMS ACO Part B Physicians File Load
| PaymentStatus |
"*Not Applicable" |
CMS ACO Part D Prescription Drug File Load
| PaymentStatus |
"*Not Applicable" |
CMS CJR DME Claim Load
| PaymentStatus |
NULL |
CMS CJR Home Health Claim Load
| PaymentStatus |
NULL |
CMS CJR Hospice Claim Load
| PaymentStatus |
NULL |
CMS CJR Inpatient Claim Load
| PaymentStatus |
NULL |
CMS CJR Outpatient Claim Load
| PaymentStatus |
NULL |
CMS CJR Part B Claim Load
| PaymentStatus |
NULL |
CMS CJR Skilled Nursing Facility Claim Load
| PaymentStatus |
NULL |
Received Claim Load
| PaymentStatus |
|
||||||
|
If AP_CLAIM.AP_STS_C is NULL then "*Unspecified" Otherwise if ZC_CLM_AP_STAT.AP_STS_C is NULL then "*Unknown" Otherwise ZC_CLM_AP_STAT.NAME |
TaxIdNumber
: stringTaxpayer identification number associated with the claim. This number identifies who receives payment for the claim.
Properties
- Data type
- string
- SQL Server data type
- nvarchar(50)
- Allows null
- No
- Default value
- empty string
- Delete value
- empty string
Data Lineage for Each Package
CMS ACO Part A Files Load
| TaxIdNumber |
"*Not Applicable" |
CMS ACO Part B DME File Load
| TaxIdNumber |
"*Not Applicable" |
CMS ACO Part B Physicians File Load
| TaxIdNumber |
|
||
|
If CLM_RNDRG_PRVDR_TAX_NUM is the same across all CLM_LINE_NUM values with the same CUR_CLM_UNIQ_ID then CLM_RNDRG_PRVDR_TAX_NUM, otherwise "*Unspecified" |
CMS ACO Part D Prescription Drug File Load
| TaxIdNumber |
|
||||
|
If PRVDR_PRSBNG_ID_QLFYR_CD = 11-TIN then CLM_PRSBNG_PRVDR_GNRC_ID_NUM Otherwise "*Unspecified" |
CMS CJR DME Claim Load
| TaxIdNumber |
NULL |
CMS CJR Home Health Claim Load
| TaxIdNumber |
NULL |
CMS CJR Hospice Claim Load
| TaxIdNumber |
NULL |
CMS CJR Inpatient Claim Load
| TaxIdNumber |
NULL |
CMS CJR Outpatient Claim Load
| TaxIdNumber |
NULL |
CMS CJR Part B Claim Load
| TaxIdNumber |
NULL |
CMS CJR Skilled Nursing Facility Claim Load
| TaxIdNumber |
NULL |
Data Aggregation Medical Claim Load
| TaxIdNumber |
|
||||
|
If BIL_PROV_TAXID is NULL THEN TAX_ID Otherwise BIL_PROV_TAXID |
Data Aggregation Pharmacy Claim Load
| TaxIdNumber |
|
||||
|
If SVC_PROV_IDENT_QUAL = "11" and SVC_PROV_IDENT is not NULL then SVC_PROV_IDENT Otherwise NULL |
Externally Adjudicated Medical Claim Load
| TaxIdNumber |
|
||||
|
If BIL_PROV_TAXID is NULL THEN TAX_ID Otherwise BIL_PROV_TAXID |
Externally Adjudicated Pharmacy Claim Load
| TaxIdNumber |
|
||||
|
If SVC_PROV_IDENT_QUAL = "11" and SVC_PROV_IDENT is not NULL then SVC_PROV_IDENT Otherwise NULL |
Payer System Medical Claim Load
| TaxIdNumber |
|
||||
|
If BIL_PROV_TAXID is NULL THEN TAX_ID Otherwise BIL_PROV_TAXID |
Payer System Pharmacy Claim Load
| TaxIdNumber |
|
||||
|
If SVC_PROV_IDENT_QUAL = "11" and SVC_PROV_IDENT is not NULL then SVC_PROV_IDENT Otherwise NULL |
Received Claim Load
| TaxIdNumber |
|
||||
|
If BIL_PROV_TAXID is NULL THEN TAX_ID Otherwise BIL_PROV_TAXID |
Received Pharmacy Claim Load
| TaxIdNumber |
|
||||
|
If SVC_PROV_IDENT_QUAL = "11" and SVC_PROV_IDENT is not NULL then SVC_PROV_IDENT Otherwise NULL |
CliaCertificationNumber
: stringCLIA (Clinical Laboratory Improvement Association) certification number received on the claim
Properties
- Data type
- string
- SQL Server data type
- nvarchar(50)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| CliaCertificationNumber |
"*Not Applicable" |
CMS ACO Part B DME File Load
| CliaCertificationNumber |
"*Not Applicable" |
CMS ACO Part B Physicians File Load
| CliaCertificationNumber |
"*Not Applicable" |
CMS ACO Part D Prescription Drug File Load
| CliaCertificationNumber |
"*Not Applicable" |
CMS CJR DME Claim Load
| CliaCertificationNumber |
"*Not Applicable" |
CMS CJR Home Health Claim Load
| CliaCertificationNumber |
"*Not Applicable" |
CMS CJR Hospice Claim Load
| CliaCertificationNumber |
"*Not Applicable" |
CMS CJR Inpatient Claim Load
| CliaCertificationNumber |
"*Not Applicable" |
CMS CJR Outpatient Claim Load
| CliaCertificationNumber |
"*Not Applicable" |
CMS CJR Part B Claim Load
| CliaCertificationNumber |
"*Not Applicable" |
CMS CJR Skilled Nursing Facility Claim Load
| CliaCertificationNumber |
"*Not Applicable" |
Data Aggregation Medical Claim Load
| CliaCertificationNumber |
|
||||
|
If CLIA_NUM is not NULL then CLIA_NUM Otherwise CLIA_NUMBER |
Data Aggregation Pharmacy Claim Load
| CliaCertificationNumber |
"*Not Applicable" |
Externally Adjudicated Medical Claim Load
| CliaCertificationNumber |
|
||||
|
If CLIA_NUM is not NULL THEN CLIA_NUM Otherwise CLIA_NUMBER |
Externally Adjudicated Pharmacy Claim Load
| CliaCertificationNumber |
"*Not Applicable" |
Payer System Medical Claim Load
| CliaCertificationNumber |
|
||||
|
If CLIA_NUM is not NULL THEN CLIA_NUM Otherwise CLIA_NUMBER |
Payer System Pharmacy Claim Load
| CliaCertificationNumber |
"*Not Applicable" |
Received Claim Load
| CliaCertificationNumber |
|
||||
|
If CLIA_NUM is not NULL THEN CLIA_NUM Otherwise CLIA_NUMBER |
Received Pharmacy Claim Load
| CliaCertificationNumber |
"*Not Applicable" |
TypeOfBillFacilityTypeCode
: integerFirst digit of the type of bill code. This indicates the type of facility.
Properties
- Data type
- integer
- SQL Server data type
- tinyint
- Allows null
- Yes
Data Lineage for Each Package
CMS ACO Part A Files Load
| TypeOfBillFacilityTypeCode |
NULL |
CMS ACO Part B DME File Load
| TypeOfBillFacilityTypeCode |
NULL |
CMS ACO Part B Physicians File Load
| TypeOfBillFacilityTypeCode |
NULL |
CMS ACO Part D Prescription Drug File Load
| TypeOfBillFacilityTypeCode |
NULL |
CMS CJR DME Claim Load
| TypeOfBillFacilityTypeCode |
NULL |
CMS CJR Home Health Claim Load
| TypeOfBillFacilityTypeCode |
NULL |
CMS CJR Hospice Claim Load
| TypeOfBillFacilityTypeCode |
NULL |
CMS CJR Inpatient Claim Load
| TypeOfBillFacilityTypeCode |
NULL |
CMS CJR Outpatient Claim Load
| TypeOfBillFacilityTypeCode |
NULL |
CMS CJR Part B Claim Load
| TypeOfBillFacilityTypeCode |
NULL |
CMS CJR Skilled Nursing Facility Claim Load
| TypeOfBillFacilityTypeCode |
NULL |
Data Aggregation Medical Claim Load
| TypeOfBillFacilityTypeCode |
NULL |
Externally Adjudicated Medical Claim Load
| TypeOfBillFacilityTypeCode |
NULL |
Payer System Medical Claim Load
| TypeOfBillFacilityTypeCode |
NULL |
Received Claim Load
| TypeOfBillFacilityTypeCode |
NULL |
TypeOfBillServiceTypeCode
: integerSecond digit of the type of bill code. This indicates the type of service provided.
Properties
- Data type
- integer
- SQL Server data type
- tinyint
- Allows null
- Yes
Data Lineage for Each Package
CMS ACO Part A Files Load
| TypeOfBillServiceTypeCode |
NULL |
CMS ACO Part B DME File Load
| TypeOfBillServiceTypeCode |
NULL |
CMS ACO Part B Physicians File Load
| TypeOfBillServiceTypeCode |
NULL |
CMS ACO Part D Prescription Drug File Load
| TypeOfBillServiceTypeCode |
NULL |
CMS CJR DME Claim Load
| TypeOfBillServiceTypeCode |
NULL |
CMS CJR Home Health Claim Load
| TypeOfBillServiceTypeCode |
NULL |
CMS CJR Hospice Claim Load
| TypeOfBillServiceTypeCode |
NULL |
CMS CJR Inpatient Claim Load
| TypeOfBillServiceTypeCode |
NULL |
CMS CJR Outpatient Claim Load
| TypeOfBillServiceTypeCode |
NULL |
CMS CJR Part B Claim Load
| TypeOfBillServiceTypeCode |
NULL |
CMS CJR Skilled Nursing Facility Claim Load
| TypeOfBillServiceTypeCode |
NULL |
Data Aggregation Medical Claim Load
| TypeOfBillServiceTypeCode |
NULL |
Externally Adjudicated Medical Claim Load
| TypeOfBillServiceTypeCode |
NULL |
Payer System Medical Claim Load
| TypeOfBillServiceTypeCode |
NULL |
Received Claim Load
| TypeOfBillServiceTypeCode |
NULL |
TypeOfBillFrequencyCode
: stringThird digit of the type of bill code. This indicates the timing of the claim.
Properties
- Data type
- string
- SQL Server data type
- nvarchar(50)
- Allows null
- No
- Default value
- empty string
- Delete value
- empty string
Data Lineage for Each Package
CMS ACO Part A Files Load
| TypeOfBillFrequencyCode |
NULL |
CMS ACO Part B DME File Load
| TypeOfBillFrequencyCode |
NULL |
CMS ACO Part B Physicians File Load
| TypeOfBillFrequencyCode |
NULL |
CMS ACO Part D Prescription Drug File Load
| TypeOfBillFrequencyCode |
NULL |
CMS CJR DME Claim Load
| TypeOfBillFrequencyCode |
NULL |
CMS CJR Home Health Claim Load
| TypeOfBillFrequencyCode |
NULL |
CMS CJR Hospice Claim Load
| TypeOfBillFrequencyCode |
NULL |
CMS CJR Inpatient Claim Load
| TypeOfBillFrequencyCode |
NULL |
CMS CJR Outpatient Claim Load
| TypeOfBillFrequencyCode |
NULL |
CMS CJR Part B Claim Load
| TypeOfBillFrequencyCode |
NULL |
CMS CJR Skilled Nursing Facility Claim Load
| TypeOfBillFrequencyCode |
NULL |
Data Aggregation Medical Claim Load
| TypeOfBillFrequencyCode |
NULL |
Externally Adjudicated Medical Claim Load
| TypeOfBillFrequencyCode |
NULL |
Payer System Medical Claim Load
| TypeOfBillFrequencyCode |
NULL |
Received Claim Load
| TypeOfBillFrequencyCode |
NULL |
VendorRelationship
: stringRelationship between the claim's vendor and payer. For Epic data, this column contains "External" if the claim originated outside the organization and "Internal" if the claim originated inside the organization.
Properties
- Data type
- string
- SQL Server data type
- nvarchar(300)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| VendorRelationship |
"*Not Applicable" |
CMS ACO Part B DME File Load
| VendorRelationship |
"*Not Applicable" |
CMS ACO Part B Physicians File Load
| VendorRelationship |
"*Not Applicable" |
CMS ACO Part D Prescription Drug File Load
| VendorRelationship |
"*Not Applicable" |
CMS CJR DME Claim Load
| VendorRelationship |
NULL |
CMS CJR Home Health Claim Load
| VendorRelationship |
NULL |
CMS CJR Hospice Claim Load
| VendorRelationship |
NULL |
CMS CJR Inpatient Claim Load
| VendorRelationship |
NULL |
CMS CJR Outpatient Claim Load
| VendorRelationship |
NULL |
CMS CJR Part B Claim Load
| VendorRelationship |
NULL |
CMS CJR Skilled Nursing Facility Claim Load
| VendorRelationship |
NULL |
Externally Adjudicated Medical Claim Load
| VendorRelationship |
NULL |
Received Claim Load
| VendorRelationship |
|
||||||
|
If AP_CLAIM_3.INT_EXT_C is NULL then "*Unspecified" Otherwise if ZC_INT_EXT.INT_EXT_C is NULL then "*Unknown" Otherwise ZC_INT_EXT.NAME |
Workflow
: stringWorkflow associated with the claim. For Epic data, this will be NULL or "AP claims" for most claims, but could also be "Export only", "Paid Claims", "Paid claims with bucket update", or "Adjudicated external claims".
Properties
- Data type
- string
- SQL Server data type
- nvarchar(300)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| Workflow |
"*Not Applicable" |
CMS ACO Part B DME File Load
| Workflow |
"*Not Applicable" |
CMS ACO Part B Physicians File Load
| Workflow |
"*Not Applicable" |
CMS ACO Part D Prescription Drug File Load
| Workflow |
"*Not Applicable" |
CMS CJR DME Claim Load
| Workflow |
NULL |
CMS CJR Home Health Claim Load
| Workflow |
NULL |
CMS CJR Hospice Claim Load
| Workflow |
NULL |
CMS CJR Inpatient Claim Load
| Workflow |
NULL |
CMS CJR Outpatient Claim Load
| Workflow |
NULL |
CMS CJR Part B Claim Load
| Workflow |
NULL |
CMS CJR Skilled Nursing Facility Claim Load
| Workflow |
NULL |
Data Aggregation Medical Claim Load
| Workflow |
|
||||||
|
If ZC_WORKFLOW.WORKFLOW_C is NULL then "*Unknown" Otherwise ZC_WORKFLOW.NAME |
Data Aggregation Pharmacy Claim Load
| Workflow |
|
||||
Externally Adjudicated Medical Claim Load
| Workflow |
|
||||||
|
If ZC_WORKFLOW.WORKFLOW_C is NULL then "*Unknown" Otherwise ZC_WORKFLOW.NAME |
Externally Adjudicated Pharmacy Claim Load
| Workflow |
|
||||
Payer System Medical Claim Load
| Workflow |
|
||||||
|
If ZC_WORKFLOW.WORKFLOW_C is NULL then "*Unknown" Otherwise ZC_WORKFLOW.NAME |
Payer System Pharmacy Claim Load
| Workflow |
|
||||
Received Claim Load
| Workflow |
|
||||||
|
If ZC_WORKFLOW.WORKFLOW_C is NULL then "*Unknown" Otherwise ZC_WORKFLOW.NAME |
Received Pharmacy Claim Load
| Workflow |
|
||||
TotalBilledAmount
: numberTotal billed amount associated with the claim
Properties
- Data type
- number
- SQL Server data type
- numeric(18,2)
- Allows null
- Yes
Data Lineage for Each Package
CMS ACO Part A Files Load
| TotalBilledAmount |
|
||
|
NULL |
CMS ACO Part B DME File Load
| TotalBilledAmount |
NULL |
CMS ACO Part B Physicians File Load
| TotalBilledAmount |
NULL |
CMS ACO Part D Prescription Drug File Load
| TotalBilledAmount |
NULL |
CMS CJR DME Claim Load
| TotalBilledAmount |
NULL |
CMS CJR Home Health Claim Load
| TotalBilledAmount |
|
||
CMS CJR Hospice Claim Load
| TotalBilledAmount |
NULL |
CMS CJR Inpatient Claim Load
| TotalBilledAmount |
|
||
CMS CJR Outpatient Claim Load
| TotalBilledAmount |
NULL |
CMS CJR Part B Claim Load
| TotalBilledAmount |
NULL |
CMS CJR Skilled Nursing Facility Claim Load
| TotalBilledAmount |
|
||
Data Aggregation Medical Claim Load
| TotalBilledAmount |
|
||
Data Aggregation Pharmacy Claim Load
| TotalBilledAmount |
|
||
Externally Adjudicated Medical Claim Load
| TotalBilledAmount |
|
||
Externally Adjudicated Pharmacy Claim Load
| TotalBilledAmount |
|
||
Payer System Medical Claim Load
| TotalBilledAmount |
|
||
Payer System Pharmacy Claim Load
| TotalBilledAmount |
|
||
Received Claim Load
| TotalBilledAmount |
|
||
Received Pharmacy Claim Load
| TotalBilledAmount |
|
||
TotalDiscountAmount
: numberTotal discount amount associated with the claim
Properties
- Data type
- number
- SQL Server data type
- numeric(18,2)
- Allows null
- Yes
Data Lineage for Each Package
CMS ACO Part A Files Load
| TotalDiscountAmount |
NULL |
CMS ACO Part B DME File Load
| TotalDiscountAmount |
NULL |
CMS ACO Part B Physicians File Load
| TotalDiscountAmount |
NULL |
CMS ACO Part D Prescription Drug File Load
| TotalDiscountAmount |
NULL |
CMS CJR DME Claim Load
| TotalDiscountAmount |
NULL |
CMS CJR Home Health Claim Load
| TotalDiscountAmount |
NULL |
CMS CJR Hospice Claim Load
| TotalDiscountAmount |
NULL |
CMS CJR Inpatient Claim Load
| TotalDiscountAmount |
NULL |
CMS CJR Outpatient Claim Load
| TotalDiscountAmount |
NULL |
CMS CJR Part B Claim Load
| TotalDiscountAmount |
NULL |
CMS CJR Skilled Nursing Facility Claim Load
| TotalDiscountAmount |
NULL |
Externally Adjudicated Medical Claim Load
| TotalDiscountAmount |
|
||
Received Claim Load
| TotalDiscountAmount |
|
||
TotalAllowedAmount
: numberTotal allowed amount associated with the claim
Properties
- Data type
- number
- SQL Server data type
- numeric(18,2)
- Allows null
- Yes
Data Lineage for Each Package
CMS ACO Part A Files Load
| TotalAllowedAmount |
NULL |
CMS ACO Part B DME File Load
| TotalAllowedAmount |
|
||||
|
If CLM_ADJSMT_TYPE_CD = 1 then the product of the sum of CLM_LINE_ALOWD_CHRG_AMT × (-1) Otherwise sum of CLM_LINE_ALOWD_CHRG_AMT |
CMS ACO Part B Physicians File Load
| TotalAllowedAmount |
|
||||
|
If CLM_ADJSMT_TYPE_CD = 1 then the product of the sum of CLM_LINE_ALOWD_CHRG_AMT × (-1) Otherwise sum of CLM_LINE_ALOWD_CHRG_AMT |
CMS ACO Part D Prescription Drug File Load
| TotalAllowedAmount |
NULL |
CMS CJR DME Claim Load
| TotalAllowedAmount |
|
||
CMS CJR Home Health Claim Load
| TotalAllowedAmount |
NULL |
CMS CJR Hospice Claim Load
| TotalAllowedAmount |
NULL |
CMS CJR Inpatient Claim Load
| TotalAllowedAmount |
NULL |
CMS CJR Outpatient Claim Load
| TotalAllowedAmount |
NULL |
CMS CJR Part B Claim Load
| TotalAllowedAmount |
|
||
CMS CJR Skilled Nursing Facility Claim Load
| TotalAllowedAmount |
NULL |
Data Aggregation Medical Claim Load
| TotalAllowedAmount |
|
||
Data Aggregation Pharmacy Claim Load
| TotalAllowedAmount |
|
||
Externally Adjudicated Medical Claim Load
| TotalAllowedAmount |
|
||
Externally Adjudicated Pharmacy Claim Load
| TotalAllowedAmount |
|
||
Payer System Medical Claim Load
| TotalAllowedAmount |
|
||
Payer System Pharmacy Claim Load
| TotalAllowedAmount |
|
||
Received Claim Load
| TotalAllowedAmount |
|
||
Received Pharmacy Claim Load
| TotalAllowedAmount |
|
||
TotalCopayAmount
: numberTotal copay amount associated with the claim
Properties
- Data type
- number
- SQL Server data type
- numeric(18,2)
- Allows null
- Yes
Data Lineage for Each Package
CMS ACO Part A Files Load
| TotalCopayAmount |
NULL |
CMS ACO Part B DME File Load
| TotalCopayAmount |
NULL |
CMS ACO Part B Physicians File Load
| TotalCopayAmount |
NULL |
CMS ACO Part D Prescription Drug File Load
| TotalCopayAmount |
NULL |
CMS CJR DME Claim Load
| TotalCopayAmount |
NULL |
CMS CJR Home Health Claim Load
| TotalCopayAmount |
NULL |
CMS CJR Hospice Claim Load
| TotalCopayAmount |
NULL |
CMS CJR Inpatient Claim Load
| TotalCopayAmount |
NULL |
CMS CJR Outpatient Claim Load
| TotalCopayAmount |
NULL |
CMS CJR Part B Claim Load
| TotalCopayAmount |
NULL |
CMS CJR Skilled Nursing Facility Claim Load
| TotalCopayAmount |
NULL |
Data Aggregation Medical Claim Load
| TotalCopayAmount |
|
||
Data Aggregation Pharmacy Claim Load
| TotalCopayAmount |
|
||
Externally Adjudicated Medical Claim Load
| TotalCopayAmount |
|
||
Externally Adjudicated Pharmacy Claim Load
| TotalCopayAmount |
|
||
Payer System Medical Claim Load
| TotalCopayAmount |
|
||
Payer System Pharmacy Claim Load
| TotalCopayAmount |
|
||
Received Claim Load
| TotalCopayAmount |
|
||
Received Pharmacy Claim Load
| TotalCopayAmount |
|
||
TotalCoinsuranceAmount
: numberTotal co-insurance amount associated with the claim
Properties
- Data type
- number
- SQL Server data type
- numeric(18,2)
- Allows null
- Yes
Data Lineage for Each Package
CMS ACO Part A Files Load
| TotalCoinsuranceAmount |
NULL |
CMS ACO Part B DME File Load
| TotalCoinsuranceAmount |
NULL |
CMS ACO Part B Physicians File Load
| TotalCoinsuranceAmount |
NULL |
CMS ACO Part D Prescription Drug File Load
| TotalCoinsuranceAmount |
NULL |
CMS CJR DME Claim Load
| TotalCoinsuranceAmount |
NULL |
CMS CJR Home Health Claim Load
| TotalCoinsuranceAmount |
NULL |
CMS CJR Hospice Claim Load
| TotalCoinsuranceAmount |
NULL |
CMS CJR Inpatient Claim Load
| TotalCoinsuranceAmount |
|
||
CMS CJR Outpatient Claim Load
| TotalCoinsuranceAmount |
NULL |
CMS CJR Part B Claim Load
| TotalCoinsuranceAmount |
NULL |
CMS CJR Skilled Nursing Facility Claim Load
| TotalCoinsuranceAmount |
|
||
Data Aggregation Medical Claim Load
| TotalCoinsuranceAmount |
|
||
Data Aggregation Pharmacy Claim Load
| TotalCoinsuranceAmount |
|
||
Externally Adjudicated Medical Claim Load
| TotalCoinsuranceAmount |
|
||
Externally Adjudicated Pharmacy Claim Load
| TotalCoinsuranceAmount |
|
||
Payer System Medical Claim Load
| TotalCoinsuranceAmount |
|
||
Payer System Pharmacy Claim Load
| TotalCoinsuranceAmount |
|
||
Received Claim Load
| TotalCoinsuranceAmount |
|
||
Received Pharmacy Claim Load
| TotalCoinsuranceAmount |
|
||
TotalDeductibleAmount
: numberTotal deductible amount associated with the claim
Properties
- Data type
- number
- SQL Server data type
- numeric(18,2)
- Allows null
- Yes
Data Lineage for Each Package
CMS ACO Part A Files Load
| TotalDeductibleAmount |
NULL |
CMS ACO Part B DME File Load
| TotalDeductibleAmount |
NULL |
CMS ACO Part B Physicians File Load
| TotalDeductibleAmount |
NULL |
CMS ACO Part D Prescription Drug File Load
| TotalDeductibleAmount |
NULL |
CMS CJR DME Claim Load
| TotalDeductibleAmount |
NULL |
CMS CJR Home Health Claim Load
| TotalDeductibleAmount |
NULL |
CMS CJR Hospice Claim Load
| TotalDeductibleAmount |
NULL |
CMS CJR Inpatient Claim Load
| TotalDeductibleAmount |
|
||
CMS CJR Outpatient Claim Load
| TotalDeductibleAmount |
NULL |
CMS CJR Part B Claim Load
| TotalDeductibleAmount |
NULL |
CMS CJR Skilled Nursing Facility Claim Load
| TotalDeductibleAmount |
|
||
Data Aggregation Medical Claim Load
| TotalDeductibleAmount |
|
||
Data Aggregation Pharmacy Claim Load
| TotalDeductibleAmount |
|
||
Externally Adjudicated Medical Claim Load
| TotalDeductibleAmount |
|
||
Externally Adjudicated Pharmacy Claim Load
| TotalDeductibleAmount |
|
||
Payer System Medical Claim Load
| TotalDeductibleAmount |
|
||
Payer System Pharmacy Claim Load
| TotalDeductibleAmount |
|
||
Received Claim Load
| TotalDeductibleAmount |
|
||
Received Pharmacy Claim Load
| TotalDeductibleAmount |
|
||
TotalNotCoveredAmount
: numberTotal not covered amount associated with the claim
Properties
- Data type
- number
- SQL Server data type
- numeric(18,2)
- Allows null
- Yes
Data Lineage for Each Package
CMS ACO Part A Files Load
| TotalNotCoveredAmount |
NULL |
CMS ACO Part B DME File Load
| TotalNotCoveredAmount |
NULL |
CMS ACO Part B Physicians File Load
| TotalNotCoveredAmount |
NULL |
CMS ACO Part D Prescription Drug File Load
| TotalNotCoveredAmount |
NULL |
CMS CJR DME Claim Load
| TotalNotCoveredAmount |
NULL |
CMS CJR Home Health Claim Load
| TotalNotCoveredAmount |
NULL |
CMS CJR Hospice Claim Load
| TotalNotCoveredAmount |
NULL |
CMS CJR Inpatient Claim Load
| TotalNotCoveredAmount |
NULL |
CMS CJR Outpatient Claim Load
| TotalNotCoveredAmount |
NULL |
CMS CJR Part B Claim Load
| TotalNotCoveredAmount |
NULL |
CMS CJR Skilled Nursing Facility Claim Load
| TotalNotCoveredAmount |
NULL |
Data Aggregation Medical Claim Load
| TotalNotCoveredAmount |
|
||
Data Aggregation Pharmacy Claim Load
| TotalNotCoveredAmount |
|
||
Externally Adjudicated Medical Claim Load
| TotalNotCoveredAmount |
|
||
Payer System Medical Claim Load
| TotalNotCoveredAmount |
|
||
Received Claim Load
| TotalNotCoveredAmount |
|
||
TotalPatientPortionAmount
: numberTotal amount associated with the claim the patient is responsible for paying. For Epic data, this is calculated as the sum of the copay, co-insurance, deductible and amount not covered.
Properties
- Data type
- number
- SQL Server data type
- numeric(18,2)
- Allows null
- Yes
Data Lineage for Each Package
CMS ACO Part A Files Load
| TotalPatientPortionAmount |
NULL |
CMS ACO Part B DME File Load
| TotalPatientPortionAmount |
NULL |
CMS ACO Part B Physicians File Load
| TotalPatientPortionAmount |
NULL |
CMS ACO Part D Prescription Drug File Load
| TotalPatientPortionAmount |
|
||||
|
If CLM_ADJSMT_TYPE_CD = 1 then CLM_LINE_BENE_PMT_AMT × (-1) Otherwise CLM_LINE_BENE_PMT_AMT |
CMS CJR DME Claim Load
| TotalPatientPortionAmount |
NULL |
CMS CJR Home Health Claim Load
| TotalPatientPortionAmount |
NULL |
CMS CJR Hospice Claim Load
| TotalPatientPortionAmount |
NULL |
CMS CJR Inpatient Claim Load
| TotalPatientPortionAmount |
NULL |
CMS CJR Outpatient Claim Load
| TotalPatientPortionAmount |
NULL |
CMS CJR Part B Claim Load
| TotalPatientPortionAmount |
NULL |
CMS CJR Skilled Nursing Facility Claim Load
| TotalPatientPortionAmount |
NULL |
Externally Adjudicated Medical Claim Load
| TotalPatientPortionAmount |
|
||
Received Claim Load
| TotalPatientPortionAmount |
|
||
TotalInsuranceAmount
: numberTotal insurance amount associated with the claim
Properties
- Data type
- number
- SQL Server data type
- numeric(18,2)
- Allows null
- Yes
Data Lineage for Each Package
CMS ACO Part A Files Load
| TotalInsuranceAmount |
NULL |
CMS ACO Part B DME File Load
| TotalInsuranceAmount |
NULL |
CMS ACO Part B Physicians File Load
| TotalInsuranceAmount |
NULL |
CMS ACO Part D Prescription Drug File Load
| TotalInsuranceAmount |
NULL |
CMS CJR DME Claim Load
| TotalInsuranceAmount |
NULL |
CMS CJR Home Health Claim Load
| TotalInsuranceAmount |
NULL |
CMS CJR Hospice Claim Load
| TotalInsuranceAmount |
NULL |
CMS CJR Inpatient Claim Load
| TotalInsuranceAmount |
NULL |
CMS CJR Outpatient Claim Load
| TotalInsuranceAmount |
NULL |
CMS CJR Part B Claim Load
| TotalInsuranceAmount |
NULL |
CMS CJR Skilled Nursing Facility Claim Load
| TotalInsuranceAmount |
NULL |
Externally Adjudicated Medical Claim Load
| TotalInsuranceAmount |
|
||
Received Claim Load
| TotalInsuranceAmount |
|
||
TotalAdjustmentAmount
: numberTotal adjustment amount associated with the claim
Properties
- Data type
- number
- SQL Server data type
- numeric(18,2)
- Allows null
- Yes
Data Lineage for Each Package
CMS ACO Part A Files Load
| TotalAdjustmentAmount |
NULL |
CMS ACO Part B DME File Load
| TotalAdjustmentAmount |
NULL |
CMS ACO Part B Physicians File Load
| TotalAdjustmentAmount |
NULL |
CMS ACO Part D Prescription Drug File Load
| TotalAdjustmentAmount |
NULL |
CMS CJR DME Claim Load
| TotalAdjustmentAmount |
NULL |
CMS CJR Home Health Claim Load
| TotalAdjustmentAmount |
NULL |
CMS CJR Hospice Claim Load
| TotalAdjustmentAmount |
NULL |
CMS CJR Inpatient Claim Load
| TotalAdjustmentAmount |
NULL |
CMS CJR Outpatient Claim Load
| TotalAdjustmentAmount |
NULL |
CMS CJR Part B Claim Load
| TotalAdjustmentAmount |
NULL |
CMS CJR Skilled Nursing Facility Claim Load
| TotalAdjustmentAmount |
NULL |
Externally Adjudicated Medical Claim Load
| TotalAdjustmentAmount |
|
||
Received Claim Load
| TotalAdjustmentAmount |
|
||
TotalNetInsuranceAmount
: numberTotal net insurance amount associated with the claim remaining after deducting all applicable adjustments and other payments from the total insurance amount
Properties
- Data type
- number
- SQL Server data type
- numeric(18,2)
- Allows null
- Yes
Data Lineage for Each Package
CMS ACO Part A Files Load
| TotalNetInsuranceAmount |
NULL |
CMS ACO Part B DME File Load
| TotalNetInsuranceAmount |
NULL |
CMS ACO Part B Physicians File Load
| TotalNetInsuranceAmount |
NULL |
CMS ACO Part D Prescription Drug File Load
| TotalNetInsuranceAmount |
NULL |
CMS CJR DME Claim Load
| TotalNetInsuranceAmount |
NULL |
CMS CJR Home Health Claim Load
| TotalNetInsuranceAmount |
NULL |
CMS CJR Hospice Claim Load
| TotalNetInsuranceAmount |
NULL |
CMS CJR Inpatient Claim Load
| TotalNetInsuranceAmount |
NULL |
CMS CJR Outpatient Claim Load
| TotalNetInsuranceAmount |
NULL |
CMS CJR Part B Claim Load
| TotalNetInsuranceAmount |
NULL |
CMS CJR Skilled Nursing Facility Claim Load
| TotalNetInsuranceAmount |
NULL |
Externally Adjudicated Medical Claim Load
| TotalNetInsuranceAmount |
|
||
Received Claim Load
| TotalNetInsuranceAmount |
|
||
TotalExceededBenefitAmount
: numberTotal amount that exceeded maximum benefit amount associated with the claim
Properties
- Data type
- number
- SQL Server data type
- numeric(18,2)
- Allows null
- Yes
Data Lineage for Each Package
CMS ACO Part A Files Load
| TotalExceededBenefitAmount |
NULL |
CMS ACO Part B DME File Load
| TotalExceededBenefitAmount |
NULL |
CMS ACO Part B Physicians File Load
| TotalExceededBenefitAmount |
NULL |
CMS ACO Part D Prescription Drug File Load
| TotalExceededBenefitAmount |
NULL |
CMS CJR DME Claim Load
| TotalExceededBenefitAmount |
NULL |
CMS CJR Home Health Claim Load
| TotalExceededBenefitAmount |
NULL |
CMS CJR Hospice Claim Load
| TotalExceededBenefitAmount |
NULL |
CMS CJR Inpatient Claim Load
| TotalExceededBenefitAmount |
NULL |
CMS CJR Outpatient Claim Load
| TotalExceededBenefitAmount |
NULL |
CMS CJR Part B Claim Load
| TotalExceededBenefitAmount |
NULL |
CMS CJR Skilled Nursing Facility Claim Load
| TotalExceededBenefitAmount |
NULL |
Externally Adjudicated Medical Claim Load
| TotalExceededBenefitAmount |
|
||
Received Claim Load
| TotalExceededBenefitAmount |
|
||
TotalWithholdingAmount
: numberTotal withholding amount associated with the claim
Properties
- Data type
- number
- SQL Server data type
- numeric(18,2)
- Allows null
- Yes
Data Lineage for Each Package
CMS ACO Part A Files Load
| TotalWithholdingAmount |
NULL |
CMS ACO Part B DME File Load
| TotalWithholdingAmount |
NULL |
CMS ACO Part B Physicians File Load
| TotalWithholdingAmount |
NULL |
CMS ACO Part D Prescription Drug File Load
| TotalWithholdingAmount |
NULL |
CMS CJR DME Claim Load
| TotalWithholdingAmount |
NULL |
CMS CJR Home Health Claim Load
| TotalWithholdingAmount |
NULL |
CMS CJR Hospice Claim Load
| TotalWithholdingAmount |
NULL |
CMS CJR Inpatient Claim Load
| TotalWithholdingAmount |
NULL |
CMS CJR Outpatient Claim Load
| TotalWithholdingAmount |
NULL |
CMS CJR Part B Claim Load
| TotalWithholdingAmount |
NULL |
CMS CJR Skilled Nursing Facility Claim Load
| TotalWithholdingAmount |
NULL |
Externally Adjudicated Medical Claim Load
| TotalWithholdingAmount |
|
||
Received Claim Load
| TotalWithholdingAmount |
|
||
TotalNetPayableAmount
: numberTotal net payable amount associated with the claim
Properties
- Data type
- number
- SQL Server data type
- numeric(18,2)
- Allows null
- Yes
Data Lineage for Each Package
CMS ACO Part A Files Load
| TotalNetPayableAmount |
|
||||
|
If CLM_ADJSMT_TYPE_CD = 1 then CLM_PMT_AMT Ã (-1) Otherwise CLM_PMT_AMT |
CMS ACO Part B DME File Load
| TotalNetPayableAmount |
|
||||
|
If CLM_ADJSMT_TYPE_CD = 1 then the product of the sum of CLM_LINE_CVRD_PD_AMT × (-1) Otherwise sum of CLM_LINE_CVRD_PD_AMT |
CMS ACO Part B Physicians File Load
| TotalNetPayableAmount |
|
||||
|
If CLM_ADJSMT_TYPE_CD = 1 then the product of the sum of CLM_LINE_CVRD_PD_AMT × (-1) Otherwise sum of CLM_LINE_CVRD_PD_AMT |
CMS ACO Part D Prescription Drug File Load
| TotalNetPayableAmount |
NULL |
CMS CJR DME Claim Load
| TotalNetPayableAmount |
|
||
CMS CJR Home Health Claim Load
| TotalNetPayableAmount |
|
||
CMS CJR Hospice Claim Load
| TotalNetPayableAmount |
|
||
CMS CJR Inpatient Claim Load
| TotalNetPayableAmount |
|
||
CMS CJR Outpatient Claim Load
| TotalNetPayableAmount |
|
||
CMS CJR Part B Claim Load
| TotalNetPayableAmount |
|
||
CMS CJR Skilled Nursing Facility Claim Load
| TotalNetPayableAmount |
|
||
Data Aggregation Medical Claim Load
| TotalNetPayableAmount |
|
||
Data Aggregation Pharmacy Claim Load
| TotalNetPayableAmount |
|
||
Externally Adjudicated Medical Claim Load
| TotalNetPayableAmount |
|
||
Externally Adjudicated Pharmacy Claim Load
| TotalNetPayableAmount |
|
||
Payer System Medical Claim Load
| TotalNetPayableAmount |
|
||
Payer System Pharmacy Claim Load
| TotalNetPayableAmount |
|
||
Received Claim Load
| TotalNetPayableAmount |
|
||
Received Pharmacy Claim Load
| TotalNetPayableAmount |
|
||
TotalInterestAmount
: numberTotal interest amount associated with the claim
Properties
- Data type
- number
- SQL Server data type
- numeric(18,2)
- Allows null
- Yes
Data Lineage for Each Package
CMS ACO Part A Files Load
| TotalInterestAmount |
NULL |
CMS ACO Part B DME File Load
| TotalInterestAmount |
NULL |
CMS ACO Part B Physicians File Load
| TotalInterestAmount |
NULL |
CMS ACO Part D Prescription Drug File Load
| TotalInterestAmount |
NULL |
CMS CJR DME Claim Load
| TotalInterestAmount |
NULL |
CMS CJR Home Health Claim Load
| TotalInterestAmount |
NULL |
CMS CJR Hospice Claim Load
| TotalInterestAmount |
NULL |
CMS CJR Inpatient Claim Load
| TotalInterestAmount |
NULL |
CMS CJR Outpatient Claim Load
| TotalInterestAmount |
NULL |
CMS CJR Part B Claim Load
| TotalInterestAmount |
NULL |
CMS CJR Skilled Nursing Facility Claim Load
| TotalInterestAmount |
NULL |
Externally Adjudicated Medical Claim Load
| TotalInterestAmount |
|
||
Received Claim Load
| TotalInterestAmount |
|
||
TotalPenaltyAmount
: numberAmount paid in penalty if the claim was paid late
Properties
- Data type
- number
- SQL Server data type
- numeric(18,2)
- Allows null
- Yes
Data Lineage for Each Package
CMS ACO Part A Files Load
| TotalPenaltyAmount |
NULL |
CMS ACO Part B DME File Load
| TotalPenaltyAmount |
NULL |
CMS ACO Part B Physicians File Load
| TotalPenaltyAmount |
NULL |
CMS ACO Part D Prescription Drug File Load
| TotalPenaltyAmount |
NULL |
CMS CJR DME Claim Load
| TotalPenaltyAmount |
NULL |
CMS CJR Home Health Claim Load
| TotalPenaltyAmount |
NULL |
CMS CJR Hospice Claim Load
| TotalPenaltyAmount |
NULL |
CMS CJR Inpatient Claim Load
| TotalPenaltyAmount |
NULL |
CMS CJR Outpatient Claim Load
| TotalPenaltyAmount |
NULL |
CMS CJR Part B Claim Load
| TotalPenaltyAmount |
NULL |
CMS CJR Skilled Nursing Facility Claim Load
| TotalPenaltyAmount |
NULL |
Externally Adjudicated Medical Claim Load
| TotalPenaltyAmount |
|
||
Received Claim Load
| TotalPenaltyAmount |
|
||
TotalCobPrimaryInsuranceAmount
: numberTotal coordination of benefits (COB) amount associated with the claim already paid on the claim by primary insurance
Properties
- Data type
- number
- SQL Server data type
- numeric(18,2)
- Allows null
- Yes
Data Lineage for Each Package
CMS ACO Part A Files Load
| TotalCobPrimaryInsuranceAmount |
NULL |
CMS ACO Part B DME File Load
| TotalCobPrimaryInsuranceAmount |
NULL |
CMS ACO Part B Physicians File Load
| TotalCobPrimaryInsuranceAmount |
NULL |
CMS ACO Part D Prescription Drug File Load
| TotalCobPrimaryInsuranceAmount |
NULL |
CMS CJR DME Claim Load
| TotalCobPrimaryInsuranceAmount |
NULL |
CMS CJR Home Health Claim Load
| TotalCobPrimaryInsuranceAmount |
NULL |
CMS CJR Hospice Claim Load
| TotalCobPrimaryInsuranceAmount |
NULL |
CMS CJR Inpatient Claim Load
| TotalCobPrimaryInsuranceAmount |
NULL |
CMS CJR Outpatient Claim Load
| TotalCobPrimaryInsuranceAmount |
NULL |
CMS CJR Part B Claim Load
| TotalCobPrimaryInsuranceAmount |
NULL |
CMS CJR Skilled Nursing Facility Claim Load
| TotalCobPrimaryInsuranceAmount |
NULL |
Externally Adjudicated Medical Claim Load
| TotalCobPrimaryInsuranceAmount |
|
||
Externally Adjudicated Pharmacy Claim Load
| TotalCobPrimaryInsuranceAmount |
|
||
Received Claim Load
| TotalCobPrimaryInsuranceAmount |
|
||
Received Pharmacy Claim Load
| TotalCobPrimaryInsuranceAmount |
|
||
TotalCobPrimaryInsurancePatientPortionAmount
: numberTotal coordination of benefits (COB) amount associated with the claim the patient is responsible for paying as adjudicated by the primary insurance
Properties
- Data type
- number
- SQL Server data type
- numeric(18,2)
- Allows null
- Yes
Data Lineage for Each Package
CMS ACO Part A Files Load
| TotalCobPrimaryInsurancePatientPortionAmount |
NULL |
CMS ACO Part B DME File Load
| TotalCobPrimaryInsurancePatientPortionAmount |
NULL |
CMS ACO Part B Physicians File Load
| TotalCobPrimaryInsurancePatientPortionAmount |
NULL |
CMS ACO Part D Prescription Drug File Load
| TotalCobPrimaryInsurancePatientPortionAmount |
NULL |
CMS CJR DME Claim Load
| TotalCobPrimaryInsurancePatientPortionAmount |
NULL |
CMS CJR Home Health Claim Load
| TotalCobPrimaryInsurancePatientPortionAmount |
NULL |
CMS CJR Hospice Claim Load
| TotalCobPrimaryInsurancePatientPortionAmount |
NULL |
CMS CJR Inpatient Claim Load
| TotalCobPrimaryInsurancePatientPortionAmount |
NULL |
CMS CJR Outpatient Claim Load
| TotalCobPrimaryInsurancePatientPortionAmount |
NULL |
CMS CJR Part B Claim Load
| TotalCobPrimaryInsurancePatientPortionAmount |
NULL |
CMS CJR Skilled Nursing Facility Claim Load
| TotalCobPrimaryInsurancePatientPortionAmount |
NULL |
Externally Adjudicated Medical Claim Load
| TotalCobPrimaryInsurancePatientPortionAmount |
|
||
Received Claim Load
| TotalCobPrimaryInsurancePatientPortionAmount |
|
||
ExternalClaim
: integer1/0 column that indicates whether the claim originated outside the organization. This column returns 1 if the claim originated outside the organization and 0 if the claim originated inside the organization.
Properties
- Data type
- integer
- SQL Server data type
- tinyint
- Allows null
- Yes
Data Lineage for Each Package
CMS ACO Part A Files Load
| ExternalClaim |
NULL |
CMS ACO Part B DME File Load
| ExternalClaim |
NULL |
CMS ACO Part B Physicians File Load
| ExternalClaim |
NULL |
CMS ACO Part D Prescription Drug File Load
| ExternalClaim |
NULL |
CMS CJR DME Claim Load
| ExternalClaim |
NULL |
CMS CJR Home Health Claim Load
| ExternalClaim |
NULL |
CMS CJR Hospice Claim Load
| ExternalClaim |
NULL |
CMS CJR Inpatient Claim Load
| ExternalClaim |
NULL |
CMS CJR Outpatient Claim Load
| ExternalClaim |
NULL |
CMS CJR Part B Claim Load
| ExternalClaim |
NULL |
CMS CJR Skilled Nursing Facility Claim Load
| ExternalClaim |
NULL |
Data Aggregation Medical Claim Load
| ExternalClaim |
NULL |
Externally Adjudicated Medical Claim Load
| ExternalClaim |
NULL |
Payer System Medical Claim Load
| ExternalClaim |
NULL |
Received Claim Load
| ExternalClaim |
NULL |
ClaimHeaderId
: stringThe identifier for a sequence of claims
Properties
- Data type
- string
- SQL Server data type
- nvarchar(100)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| ClaimHeaderId |
CMS ACO Part B DME File Load
| ClaimHeaderId |
CMS ACO Part B Physicians File Load
| ClaimHeaderId |
CMS ACO Part D Prescription Drug File Load
| ClaimHeaderId |
CMS CJR DME Claim Load
| ClaimHeaderId |
CMS CJR Home Health Claim Load
| ClaimHeaderId |
CMS CJR Hospice Claim Load
| ClaimHeaderId |
CMS CJR Inpatient Claim Load
| ClaimHeaderId |
CMS CJR Outpatient Claim Load
| ClaimHeaderId |
CMS CJR Part B Claim Load
| ClaimHeaderId |
CMS CJR Skilled Nursing Facility Claim Load
| ClaimHeaderId |
Data Aggregation Medical Claim Load
| ClaimHeaderId |
|
||
Data Aggregation Pharmacy Claim Load
| ClaimHeaderId |
|
||
Externally Adjudicated Medical Claim Load
| ClaimHeaderId |
Externally Adjudicated Pharmacy Claim Load
| ClaimHeaderId |
Payer System Medical Claim Load
| ClaimHeaderId |
|
||
Payer System Pharmacy Claim Load
| ClaimHeaderId |
|
||
Received Claim Load
| ClaimHeaderId |
Received Pharmacy Claim Load
| ClaimHeaderId |
AdjustmentSequence
: stringSequence number indicating the claim's ordinal position in a sequence of claim adjustments. 0 represents the original.
Properties
- Data type
- string
- SQL Server data type
- nvarchar(50)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| AdjustmentSequence |
CMS ACO Part B DME File Load
| AdjustmentSequence |
CMS ACO Part B Physicians File Load
| AdjustmentSequence |
CMS ACO Part D Prescription Drug File Load
| AdjustmentSequence |
CMS CJR DME Claim Load
| AdjustmentSequence |
CMS CJR Home Health Claim Load
| AdjustmentSequence |
CMS CJR Hospice Claim Load
| AdjustmentSequence |
CMS CJR Inpatient Claim Load
| AdjustmentSequence |
CMS CJR Outpatient Claim Load
| AdjustmentSequence |
CMS CJR Part B Claim Load
| AdjustmentSequence |
CMS CJR Skilled Nursing Facility Claim Load
| AdjustmentSequence |
Data Aggregation Medical Claim Load
| AdjustmentSequence |
|
||
Data Aggregation Pharmacy Claim Load
| AdjustmentSequence |
|
||
Externally Adjudicated Medical Claim Load
| AdjustmentSequence |
Externally Adjudicated Pharmacy Claim Load
| AdjustmentSequence |
Payer System Medical Claim Load
| AdjustmentSequence |
|
||
Payer System Pharmacy Claim Load
| AdjustmentSequence |
|
||
Received Claim Load
| AdjustmentSequence |
Received Pharmacy Claim Load
| AdjustmentSequence |
SourceKey
: integerThe source from which a claim was loaded
Properties
- Data type
- integer
- SQL Server data type
- bigint
- Allows null
- No
- Default value
- -1
- Delete value
- -3
Data Lineage for Each Package
CMS ACO Part A Files Load
| SourceId | |
| SourceIdType |
CMS ACO Part B DME File Load
| SourceId | |
| SourceIdType |
CMS ACO Part B Physicians File Load
| SourceId | |
| SourceIdType |
CMS ACO Part D Prescription Drug File Load
| SourceId | |
| SourceIdType |
CMS CJR DME Claim Load
| SourceId | |
| SourceIdType |
CMS CJR Home Health Claim Load
| SourceId | |
| SourceIdType |
CMS CJR Hospice Claim Load
| SourceId | |
| SourceIdType |
CMS CJR Inpatient Claim Load
| SourceId | |
| SourceIdType |
CMS CJR Outpatient Claim Load
| SourceId | |
| SourceIdType |
CMS CJR Part B Claim Load
| SourceId | |
| SourceIdType |
CMS CJR Skilled Nursing Facility Claim Load
| SourceId | |
| SourceIdType |
Data Aggregation Medical Claim Load
| SourceId |
|
||
| SourceIdType |
Data Aggregation Pharmacy Claim Load
| SourceId |
|
||
| SourceIdType |
Externally Adjudicated Medical Claim Load
| SourceId | |
| SourceIdType |
Externally Adjudicated Pharmacy Claim Load
| SourceId | |
| SourceIdType |
Payer System Medical Claim Load
| SourceId |
|
||
| SourceIdType |
Payer System Pharmacy Claim Load
| SourceId |
|
||
| SourceIdType |
Received Claim Load
| SourceId | |
| SourceIdType |
Received Pharmacy Claim Load
| SourceId | |
| SourceIdType |
IsPatientSubscriber
: integer1/0 column that indicates whether the patient associated with the claim is also the subscriber of the billed coverage
Properties
- Data type
- integer
- SQL Server data type
- tinyint
- Allows null
- Yes
Data Lineage for Each Package
CMS ACO Part A Files Load
| IsPatientSubscriber |
NULL |
CMS ACO Part B DME File Load
| IsPatientSubscriber |
NULL |
CMS ACO Part B Physicians File Load
| IsPatientSubscriber |
NULL |
CMS ACO Part D Prescription Drug File Load
| IsPatientSubscriber |
NULL |
CMS CJR DME Claim Load
| IsPatientSubscriber |
NULL |
CMS CJR Home Health Claim Load
| IsPatientSubscriber |
NULL |
CMS CJR Hospice Claim Load
| IsPatientSubscriber |
NULL |
CMS CJR Inpatient Claim Load
| IsPatientSubscriber |
NULL |
CMS CJR Outpatient Claim Load
| IsPatientSubscriber |
NULL |
CMS CJR Part B Claim Load
| IsPatientSubscriber |
NULL |
CMS CJR Skilled Nursing Facility Claim Load
| IsPatientSubscriber |
NULL |
Data Aggregation Medical Claim Load
| IsPatientSubscriber |
NULL |
Data Aggregation Pharmacy Claim Load
| IsPatientSubscriber |
NULL |
Externally Adjudicated Medical Claim Load
| IsPatientSubscriber |
|
||||
|
If SUB_SELF_REL_CODE = "18" then 1 Otherwise if RECORD_ID is not NULL then 0 |
Externally Adjudicated Pharmacy Claim Load
| IsPatientSubscriber |
NULL |
Payer System Medical Claim Load
| IsPatientSubscriber |
NULL |
Payer System Pharmacy Claim Load
| IsPatientSubscriber |
NULL |
Received Claim Load
| IsPatientSubscriber |
|
||||
|
If SUB_SELF_REL_CODE = "18" then 1 Otherwise if RECORD_ID is not NULL then 0 |
Received Pharmacy Claim Load
| IsPatientSubscriber |
NULL |
IsClinicallyValid
: integer1/0 column that indicates whether the clinical information on this claim can reliably be used. This column returns 1 if the clinical information on the claim can be used and 0 if the information is suspect or invalid. If this claim's IdType is included in the 'IdTypes Excluded from IsClinicallyValid Automatic Calculation' configuration for ReceivedClaimFact, then this value is imported from source data. Otherwise this value is automatically set to 1 for claims that are not adjusted or cancelled by other claims, are not pharmacy claims that have been denied, and where IsClinicallyValidForcedToZero is 0.
Properties
- Data type
- integer
- SQL Server data type
- tinyint
- Allows null
- Yes
Data Lineage for Each Package
CMS ACO Part A Files Load
| IsClinicallyValid |
|
||||||||||||
|
If the claim is the last claim in the sequence among claims with CLM_ADJSMT_TYPE_CD ???¢ã¡ã? 1-Cancelation Claim and with the same PRVDR_OSCAR_NUM, CLM_FROM_DT, CLM_THRU_DT, and BENE_EQTBL_BIC_HICN_NUM then "1", otherwise "0" |
CMS ACO Part B DME File Load
| IsClinicallyValid |
|
||||||||
|
If the claim is the last claim in the sequence among claims with CLM_ADJSMT_TYPE_CD ≠1-Cancelation Claim and with the same CLM_CNTL_NUM and BENE_EQTBL_BIC_HICN_NUM then "1", otherwise "0" |
CMS ACO Part B Physicians File Load
| IsClinicallyValid |
|
||||||||
|
If the claim is the last claim in the sequence among claims with CLM_ADJSMT_TYPE_CD ≠1-Cancelation Claim and with the same CLM_CNTL_NUM and BENE_EQTBL_BIC_HICN_NUM then "1", otherwise "0" |
CMS ACO Part D Prescription Drug File Load
| IsClinicallyValid |
|
||||||||||||||||
|
If the claim has the most recent CLM_IDR_LD_DT among claims having the same CLM_LINE_FROM_DT, PRVDR_SRVC_ID_QLFYR_CD, CLM_SRVC_PRVDR_GNRC_ID_NUM, CLM_DSPNSNG_STUS_CD, CLM_LINE_RX_SRVC_RFRNC_NUM, and CLM_LINE_RX_FILL_NUM and CLM_ADJSMT_TYPE_CD ≠1-Cancelation Claim then 1 Otherwise 0 |
CMS CJR DME Claim Load
| IsClinicallyValid |
1 |
CMS CJR Home Health Claim Load
| IsClinicallyValid |
1 |
CMS CJR Hospice Claim Load
| IsClinicallyValid |
1 |
CMS CJR Inpatient Claim Load
| IsClinicallyValid |
1 |
CMS CJR Outpatient Claim Load
| IsClinicallyValid |
1 |
CMS CJR Part B Claim Load
| IsClinicallyValid |
1 |
CMS CJR Skilled Nursing Facility Claim Load
| IsClinicallyValid |
1 |
Data Aggregation Medical Claim Load
| IsClinicallyValid |
|
||
Data Aggregation Pharmacy Claim Load
| IsClinicallyValid |
|
||
Externally Adjudicated Medical Claim Load
| IsClinicallyValid |
|
||||||||||||||
|
If CLM_FREQ_CODE_C = 8 - Cancel/Void Claim then 0 Otherwise if ADJST_CLM_ID is not null then 0 Otherwise if ORIG_REV_CLM_ID is not null then 0 Otherwise if there exists a claim where ORIG_REV_CLM_ID = CLAIM_ID then 0 Otherwise if IS_INVLD_ADJ_SEQ_YN = "Y" then 0 Otherwise if OVERRIDE_INVALID_YN = "N" then 1 Otherwise if OVERRIDE_INVALID_YN = "Y" then 0 Otherwise if INVALID_YN = "Y" then 0 Otherwise 1 |
Externally Adjudicated Pharmacy Claim Load
| IsClinicallyValid |
|
||||||||||||||
|
If AP_CLM_RX.ADJUST_BY_CLAIM_ID is not null then 0 Otherwise if AP_CLM_RX.ORIG_OF_REV_CLAIM_ID is not null then 0 Otherwise if there exists a claim where ORIG_REV_CLM_ID = CLAIM_ID then 0 Otherwise if AP_CLM_RX.CLM_STATUS_C = 3-"Denied" then 0 Otherwise if AP_CLM_RX.IS_INVLD_ADJ_SEQ_RX_YN = "Y" then 0 Otherwise if AP_CLM_RX.OVERRIDE_INVALID_CLM_YN = "N" then 1 Otherwise if AP_CLM_RX.OVERRIDE_INVALID_CLM_YN = "Y" then 0 Otherwise if AP_CLM_RX.INVALID_CLM_YN = "Y" then 0 Otherwise 1 |
Payer System Medical Claim Load
| IsClinicallyValid |
|
||
Payer System Pharmacy Claim Load
| IsClinicallyValid |
|
||
Received Claim Load
| IsClinicallyValid |
|
||||||||||||||
|
If CLM_FREQ_CODE_C = 8 - Cancel/Void Claim then 0 Otherwise if ADJST_CLM_ID is not null then 0 Otherwise if ORIG_REV_CLM_ID is not null then 0 Otherwise if there exists a claim where ORIG_REV_CLM_ID = CLAIM_ID then 0 Otherwise if IS_INVLD_ADJ_SEQ_YN = "Y" then 0 Otherwise if OVERRIDE_INVALID_YN = "N" then 1 Otherwise if OVERRIDE_INVALID_YN = "Y" then 0 Otherwise if INVALID_YN = "Y" then 0 Otherwise 1 |
Received Pharmacy Claim Load
| IsClinicallyValid |
|
||||||||||||
|
If AP_CLM_RX.ADJUST_BY_CLAIM_ID is not null then 0 Otherwise if AP_CLM_RX.ORIG_OF_REV_CLAIM_ID is not null then 0 Otherwise if there exists a claim where ORIG_REV_CLM_ID = CLAIM_ID then 0 Otherwise if AP_CLM_RX.CLM_STATUS_C = 3-"Denied" then 0 Otherwise if AP_CLM_RX.IS_INVLD_ADJ_SEQ_RX_YN = "Y" then 0 Otherwise if AP_CLM_RX.OVERRIDE_INVALID_CLM_YN = "N" then 1 Otherwise if AP_CLM_RX.OVERRIDE_INVALID_CLM_YN = "Y" then 0 Otherwise if AP_CLM_RX.INVALID_CLM_YN = "Y" then 0 Otherwise 1 |
IsClinicallyValidForcedToZero
: integer1/0 column that indicated whether the entire claim should not have been used for clinical analyses, regardless of whether the claim meets other criteria for determining IsClinicallyValid. This column returns 1 if IsClinicallyValid has been overridden to 0 (not clinically valid) for all rows in ReceivedClaimFact, ReceivedClaimProcedureFact, and ReceivedClaimMedicationFact that share this ReceivedClaimKey, regardless of any value otherwise calculated or imported into IsClinicallyValid.
Properties
- Data type
- integer
- SQL Server data type
- tinyint
- Allows null
- No
- Default value
- 0
- Delete value
- 0
Data Lineage for Each Package
CMS ACO Part A Files Load
| IsClinicallyValidForcedToZero |
CMS ACO Part B DME File Load
| IsClinicallyValidForcedToZero |
CMS ACO Part B Physicians File Load
| IsClinicallyValidForcedToZero |
CMS ACO Part D Prescription Drug File Load
| IsClinicallyValidForcedToZero |
CMS CJR DME Claim Load
| IsClinicallyValidForcedToZero |
CMS CJR Home Health Claim Load
| IsClinicallyValidForcedToZero |
CMS CJR Hospice Claim Load
| IsClinicallyValidForcedToZero |
CMS CJR Inpatient Claim Load
| IsClinicallyValidForcedToZero |
CMS CJR Outpatient Claim Load
| IsClinicallyValidForcedToZero |
CMS CJR Part B Claim Load
| IsClinicallyValidForcedToZero |
CMS CJR Skilled Nursing Facility Claim Load
| IsClinicallyValidForcedToZero |
Data Aggregation Medical Claim Load
| IsClinicallyValidForcedToZero |
|
||||||
Data Aggregation Pharmacy Claim Load
| IsClinicallyValidForcedToZero |
|
||||||
Externally Adjudicated Medical Claim Load
| IsClinicallyValidForcedToZero |
|
||||
|
If OVERRIDE_INVALID_YN = "N" THEN 0 Otherwise if OVERRIDE_INVALID_YN = "Y" THEN 1 Otherwise if INVALID_YN = "Y" THEN 1 Otherwise 0 |
Externally Adjudicated Pharmacy Claim Load
| IsClinicallyValidForcedToZero |
|
||||
|
If AP_CLM_RX.OVERRIDE_INVALID_CLM_YN = "N" THEN 0 Otherwise if AP_CLM_RX.OVERRIDE_INVALID_CLM_YN = "Y" THEN 1 Otherwise if AP_CLM_RX.INVALID_CLM_YN = "Y" THEN 1 Otherwise 0 |
Payer System Medical Claim Load
| IsClinicallyValidForcedToZero |
|
||||||
Payer System Pharmacy Claim Load
| IsClinicallyValidForcedToZero |
|
||||||
Received Claim Load
| IsClinicallyValidForcedToZero |
|
||||
|
If OVERRIDE_INVALID_YN = "N" THEN 0 Otherwise if OVERRIDE_INVALID_YN = "Y" THEN 1 Otherwise if INVALID_YN = "Y" THEN 1 Otherwise 0 |
Received Pharmacy Claim Load
| IsClinicallyValidForcedToZero |
|
||||
|
If AP_CLM_RX.OVERRIDE_INVALID_CLM_YN = "N" THEN 0 Otherwise if AP_CLM_RX.OVERRIDE_INVALID_CLM_YN = "Y" THEN 1 Otherwise if AP_CLM_RX.INVALID_CLM_YN = "Y" THEN 1 Otherwise 0 |
IsCurrentInClaimSequence
: integer1/0 column that indicates that the claim is a recent action within its adjustment sequence. If claim level adjustment sequences are used then a claim will be current if the claim is not adjusted or reversed. If line level adjustment sequences are used then a claim will be current if one of its associated procedures is current.
Properties
- Data type
- integer
- SQL Server data type
- tinyint
- Allows null
- Yes
- Delete value
- 0
Data Lineage for Each Package
CMS ACO Part A Files Load
| IsCurrentInClaimSequence |
NULL |
CMS ACO Part B DME File Load
| IsCurrentInClaimSequence |
NULL |
CMS ACO Part B Physicians File Load
| IsCurrentInClaimSequence |
NULL |
CMS ACO Part D Prescription Drug File Load
| IsCurrentInClaimSequence |
NULL |
CMS CJR DME Claim Load
| IsCurrentInClaimSequence |
NULL |
CMS CJR Home Health Claim Load
| IsCurrentInClaimSequence |
NULL |
CMS CJR Hospice Claim Load
| IsCurrentInClaimSequence |
NULL |
CMS CJR Inpatient Claim Load
| IsCurrentInClaimSequence |
NULL |
CMS CJR Outpatient Claim Load
| IsCurrentInClaimSequence |
NULL |
CMS CJR Part B Claim Load
| IsCurrentInClaimSequence |
NULL |
CMS CJR Skilled Nursing Facility Claim Load
| IsCurrentInClaimSequence |
NULL |
Data Aggregation Medical Claim Load
| IsCurrentInClaimSequence |
NULL |
Externally Adjudicated Medical Claim Load
| IsCurrentInClaimSequence |
NULL |
Payer System Medical Claim Load
| IsCurrentInClaimSequence |
NULL |
Received Claim Load
| IsCurrentInClaimSequence |
NULL |
IsCorrectionOfPayee
: integer1/0 column that indicates whether an adjustment claim included a change to the vendor being paid. This column returns 1 if the claim is an adjustment and the vendor on this claim is different than the vendor on the adjusted claim and 0 if the claim is not an adjustment or is an adjustment and the vendor on this and the adjusted claim are the same.
Properties
- Data type
- integer
- SQL Server data type
- tinyint
- Allows null
- Yes
- Delete value
- 0
Data Lineage for Each Package
CMS ACO Part A Files Load
| IsCorrectionOfPayee |
NULL |
CMS ACO Part B DME File Load
| IsCorrectionOfPayee |
NULL |
CMS ACO Part B Physicians File Load
| IsCorrectionOfPayee |
NULL |
CMS ACO Part D Prescription Drug File Load
| IsCorrectionOfPayee |
NULL |
CMS CJR DME Claim Load
| IsCorrectionOfPayee |
NULL |
CMS CJR Home Health Claim Load
| IsCorrectionOfPayee |
NULL |
CMS CJR Hospice Claim Load
| IsCorrectionOfPayee |
NULL |
CMS CJR Inpatient Claim Load
| IsCorrectionOfPayee |
NULL |
CMS CJR Outpatient Claim Load
| IsCorrectionOfPayee |
NULL |
CMS CJR Part B Claim Load
| IsCorrectionOfPayee |
NULL |
CMS CJR Skilled Nursing Facility Claim Load
| IsCorrectionOfPayee |
NULL |
Externally Adjudicated Medical Claim Load
| IsCorrectionOfPayee |
0 |
Received Claim Load
| IsCorrectionOfPayee |
|
||||||
|
If AP_CLAIM.ORIG_ADJST_CLM_ID is NULL and AP_CLAIM.ORIG_REV_CLM_ID is NULL and AP_CLAIM_2.ORIG_ACT_ADJ_CLM_ID is not null then 1 Otherwise 0 |
IsValidClaimSequence
: integer1/0 column that indicates whether the claim sequence is valid and that dollar amount summations across the sequence will balance out to what was truly paid. If 0 then you should only sum dollar amounts from the claim in the sequence with IsCurrentInClaimSequence set to 1.
Properties
- Data type
- integer
- SQL Server data type
- tinyint
- Allows null
- Yes
- Default value
- 1
- Delete value
- 0
IsFormTypeFromSourceData
: integer1/0 column that indicates whether the FormType column contains a value assigned in the source data. This column returns 1 if the FormType column contains a value assigned in the source and 0 if the FormType column was derived.
Properties
- Data type
- integer
- SQL Server data type
- tinyint
- Allows null
- Yes
Data Lineage for Each Package
CMS ACO Part A Files Load
| IsFormTypeFromSourceData |
CMS ACO Part B DME File Load
| IsFormTypeFromSourceData |
CMS ACO Part B Physicians File Load
| IsFormTypeFromSourceData |
CMS ACO Part D Prescription Drug File Load
| IsFormTypeFromSourceData |
CMS CJR DME Claim Load
| IsFormTypeFromSourceData |
CMS CJR Home Health Claim Load
| IsFormTypeFromSourceData |
CMS CJR Hospice Claim Load
| IsFormTypeFromSourceData |
CMS CJR Inpatient Claim Load
| IsFormTypeFromSourceData |
CMS CJR Outpatient Claim Load
| IsFormTypeFromSourceData |
CMS CJR Part B Claim Load
| IsFormTypeFromSourceData |
CMS CJR Skilled Nursing Facility Claim Load
| IsFormTypeFromSourceData |
Data Aggregation Medical Claim Load
| IsFormTypeFromSourceData |
Externally Adjudicated Medical Claim Load
| IsFormTypeFromSourceData |
Payer System Medical Claim Load
| IsFormTypeFromSourceData |
Received Claim Load
| IsFormTypeFromSourceData |
WasPayeeCorrected
: integer1/0 column that indicates whether an adjustment to this claim included a change to the vendor being paid. This column returns 1 if the claim was adjusted and the vendor on this claim is different than the vendor on the adjustment claim and 0 if the claim was not adjusted or was adjusted and the vendor on this and the adjustment claim are the same.
Properties
- Data type
- integer
- SQL Server data type
- tinyint
- Allows null
- Yes
- Delete value
- 0
Data Lineage for Each Package
CMS ACO Part A Files Load
| WasPayeeCorrected |
NULL |
CMS ACO Part B DME File Load
| WasPayeeCorrected |
NULL |
CMS ACO Part B Physicians File Load
| WasPayeeCorrected |
NULL |
CMS ACO Part D Prescription Drug File Load
| WasPayeeCorrected |
NULL |
CMS CJR DME Claim Load
| WasPayeeCorrected |
NULL |
CMS CJR Home Health Claim Load
| WasPayeeCorrected |
NULL |
CMS CJR Hospice Claim Load
| WasPayeeCorrected |
NULL |
CMS CJR Inpatient Claim Load
| WasPayeeCorrected |
NULL |
CMS CJR Outpatient Claim Load
| WasPayeeCorrected |
NULL |
CMS CJR Part B Claim Load
| WasPayeeCorrected |
NULL |
CMS CJR Skilled Nursing Facility Claim Load
| WasPayeeCorrected |
NULL |
Externally Adjudicated Medical Claim Load
| WasPayeeCorrected |
0 |
Received Claim Load
| WasPayeeCorrected |
|
||
|
If there exists a claim where its ORIG_ACT_ADJ_CLM_ID is this claim's Id then 1 Otherwise 0 |
IsBehavioralHealth
: integer1/0 column that indicates whether the claim is related to behavioral health. 1 is stored if it is related, 0 if not. If not supplied by import, it is calculated from ClaimSensitivityConfigurationFact.
Properties
- Data type
- integer
- SQL Server data type
- tinyint
- Allows null
- No
- Default value
- 0
- Delete value
- 0
Data Lineage for Each Package
CMS ACO Part A Files Load
| IsBehavioralHealth |
NULL |
CMS ACO Part B DME File Load
| IsBehavioralHealth |
NULL |
CMS ACO Part B Physicians File Load
| IsBehavioralHealth |
NULL |
CMS ACO Part D Prescription Drug File Load
| IsBehavioralHealth |
NULL |
CMS CJR DME Claim Load
| IsBehavioralHealth |
NULL |
CMS CJR Home Health Claim Load
| IsBehavioralHealth |
NULL |
CMS CJR Hospice Claim Load
| IsBehavioralHealth |
NULL |
CMS CJR Inpatient Claim Load
| IsBehavioralHealth |
NULL |
CMS CJR Outpatient Claim Load
| IsBehavioralHealth |
NULL |
CMS CJR Part B Claim Load
| IsBehavioralHealth |
NULL |
CMS CJR Skilled Nursing Facility Claim Load
| IsBehavioralHealth |
NULL |
Data Aggregation Medical Claim Load
| IsBehavioralHealth |
|
||
|
If there exists a row for the claim where SENSITIVITY_TYPE_C = 2-Behavioral Health then 1 Otherwise 0 |
Data Aggregation Pharmacy Claim Load
| IsBehavioralHealth |
|
||
|
If there exists a row for the claim where SENSITIVITY_TYPE_C = 2-Behavioral Health then 1 Otherwise 0 |
Externally Adjudicated Medical Claim Load
| IsBehavioralHealth |
|
||
|
If there exists a row for the claim where SENSITIVITY_TYPE_C = 2-Behavioral Health then 1 Otherwise 0 |
Externally Adjudicated Pharmacy Claim Load
| IsBehavioralHealth |
|
||
|
If there exists a row for the claim where SENSITIVITY_TYPE_C = 2-Behavioral Health then 1 Otherwise 0 |
Payer System Medical Claim Load
| IsBehavioralHealth |
|
||
|
If there exists a row for the claim where SENSITIVITY_TYPE_C = 2-Behavioral Health then 1 Otherwise 0 |
Payer System Pharmacy Claim Load
| IsBehavioralHealth |
|
||
|
If there exists a row for the claim where SENSITIVITY_TYPE_C = 2-Behavioral Health then 1 Otherwise 0 |
Received Claim Load
| IsBehavioralHealth |
|
||
|
If there exists a row for the claim where SENSITIVITY_TYPE_C = 2-Behavioral Health then 1 Otherwise 0 |
Received Pharmacy Claim Load
| IsBehavioralHealth |
|
||
|
If there exists a row for the claim where SENSITIVITY_TYPE_C = 2-Behavioral Health then 1 Otherwise 0 |
IsSubstanceAbuse
: integer1/0 column that indicates whether the claim is related to substance abuse. 1 is stored if it is related, 0 if not. If not supplied by import, it is calculated from ClaimSensitivityConfigurationFact. Substance abuse may also be referred to as alcohol and other drug abuse (AODA).
Properties
- Data type
- integer
- SQL Server data type
- tinyint
- Allows null
- No
- Default value
- 0
- Delete value
- 0
Data Lineage for Each Package
CMS ACO Part A Files Load
| IsSubstanceAbuse |
NULL |
CMS ACO Part B DME File Load
| IsSubstanceAbuse |
NULL |
CMS ACO Part B Physicians File Load
| IsSubstanceAbuse |
NULL |
CMS ACO Part D Prescription Drug File Load
| IsSubstanceAbuse |
NULL |
CMS CJR DME Claim Load
| IsSubstanceAbuse |
NULL |
CMS CJR Home Health Claim Load
| IsSubstanceAbuse |
NULL |
CMS CJR Hospice Claim Load
| IsSubstanceAbuse |
NULL |
CMS CJR Inpatient Claim Load
| IsSubstanceAbuse |
NULL |
CMS CJR Outpatient Claim Load
| IsSubstanceAbuse |
NULL |
CMS CJR Part B Claim Load
| IsSubstanceAbuse |
NULL |
CMS CJR Skilled Nursing Facility Claim Load
| IsSubstanceAbuse |
NULL |
Data Aggregation Medical Claim Load
| IsSubstanceAbuse |
|
||
|
If there exists a row for the claim where SENSITIVITY_TYPE_C = 1-Substance Abuse then 1 Otherwise 0 |
Data Aggregation Pharmacy Claim Load
| IsSubstanceAbuse |
|
||
|
If there exists a row for the claim where SENSITIVITY_TYPE_C = Substance Abuse then 1 Otherwise 0 |
Externally Adjudicated Medical Claim Load
| IsSubstanceAbuse |
|
||
|
If there exists a row for the claim where SENSITIVITY_TYPE_C = 1-Substance Abuse then 1 Otherwise 0 |
Externally Adjudicated Pharmacy Claim Load
| IsSubstanceAbuse |
|
||
|
If there exists a row for the claim where SENSITIVITY_TYPE_C = Substance Abuse then 1 Otherwise 0 |
Payer System Medical Claim Load
| IsSubstanceAbuse |
|
||
|
If there exists a row for the claim where SENSITIVITY_TYPE_C = 1-Substance Abuse then 1 Otherwise 0 |
Payer System Pharmacy Claim Load
| IsSubstanceAbuse |
|
||
|
If there exists a row for the claim where SENSITIVITY_TYPE_C = Substance Abuse then 1 Otherwise 0 |
Received Claim Load
| IsSubstanceAbuse |
|
||
|
If there exists a row for the claim where SENSITIVITY_TYPE_C = 1-Substance Abuse then 1 Otherwise 0 |
Received Pharmacy Claim Load
| IsSubstanceAbuse |
|
||
|
If there exists a row for the claim where SENSITIVITY_TYPE_C = Substance Abuse then 1 Otherwise 0 |
IsInterpretedClaimTypeFromSourceData
: integer1/0 column that indicates whether the InterpretedClaimType column contains a value assigned in the source data. This column returns 1 if the InterpretedClaimType column contains a value assigned in the source and 0 if the InterpretedClaimType column was derived.
Properties
- Data type
- integer
- SQL Server data type
- tinyint
- Allows null
- Yes
Data Lineage for Each Package
CMS ACO Part A Files Load
| IsInterpretedClaimTypeFromSourceData |
CMS ACO Part B DME File Load
| IsInterpretedClaimTypeFromSourceData |
CMS ACO Part B Physicians File Load
| IsInterpretedClaimTypeFromSourceData |
CMS ACO Part D Prescription Drug File Load
| IsInterpretedClaimTypeFromSourceData |
CMS CJR DME Claim Load
| IsInterpretedClaimTypeFromSourceData |
CMS CJR Home Health Claim Load
| IsInterpretedClaimTypeFromSourceData |
CMS CJR Hospice Claim Load
| IsInterpretedClaimTypeFromSourceData |
CMS CJR Inpatient Claim Load
| IsInterpretedClaimTypeFromSourceData |
CMS CJR Outpatient Claim Load
| IsInterpretedClaimTypeFromSourceData |
CMS CJR Part B Claim Load
| IsInterpretedClaimTypeFromSourceData |
CMS CJR Skilled Nursing Facility Claim Load
| IsInterpretedClaimTypeFromSourceData |
Data Aggregation Medical Claim Load
| IsInterpretedClaimTypeFromSourceData |
Externally Adjudicated Medical Claim Load
| IsInterpretedClaimTypeFromSourceData |
Payer System Medical Claim Load
| IsInterpretedClaimTypeFromSourceData |
Received Claim Load
| IsInterpretedClaimTypeFromSourceData |
IsIsSubstanceAbuseFromSourceData
: integer1/0 column that indicates whether the IsSubstanceAbuse column contains a value assigned in the source data. This column returns 1 if the IsSubstanceAbuse column contains a value assigned in the source and 0 if the IsSubstanceAbuse column was derived. This is automatically calculated and is not expected to be populated directly (any value imported will be overwritten).
Properties
- Data type
- integer
- SQL Server data type
- tinyint
- Allows null
- No
- Default value
- 0
- Delete value
- 1
Data Lineage for Each Package
CMS ACO Part A Files Load
| IsIsSubstanceAbuseFromSourceData |
CMS ACO Part B DME File Load
| IsIsSubstanceAbuseFromSourceData |
CMS ACO Part B Physicians File Load
| IsIsSubstanceAbuseFromSourceData |
CMS ACO Part D Prescription Drug File Load
| IsIsSubstanceAbuseFromSourceData |
CMS CJR DME Claim Load
| IsIsSubstanceAbuseFromSourceData |
CMS CJR Home Health Claim Load
| IsIsSubstanceAbuseFromSourceData |
CMS CJR Hospice Claim Load
| IsIsSubstanceAbuseFromSourceData |
CMS CJR Inpatient Claim Load
| IsIsSubstanceAbuseFromSourceData |
CMS CJR Outpatient Claim Load
| IsIsSubstanceAbuseFromSourceData |
CMS CJR Part B Claim Load
| IsIsSubstanceAbuseFromSourceData |
CMS CJR Skilled Nursing Facility Claim Load
| IsIsSubstanceAbuseFromSourceData |
Data Aggregation Medical Claim Load
| IsIsSubstanceAbuseFromSourceData |
1 |
Data Aggregation Pharmacy Claim Load
| IsIsSubstanceAbuseFromSourceData |
1 |
Externally Adjudicated Medical Claim Load
| IsIsSubstanceAbuseFromSourceData |
1 |
Externally Adjudicated Pharmacy Claim Load
| IsIsSubstanceAbuseFromSourceData |
1 |
Payer System Medical Claim Load
| IsIsSubstanceAbuseFromSourceData |
1 |
Payer System Pharmacy Claim Load
| IsIsSubstanceAbuseFromSourceData |
1 |
Received Claim Load
| IsIsSubstanceAbuseFromSourceData |
1 |
Received Pharmacy Claim Load
| IsIsSubstanceAbuseFromSourceData |
1 |
IsIsBehavioralHealthFromSourceData
: integer1/0 column that indicates whether the IsBehavioralHealth column contains a value assigned in the source data. This column returns 1 if the IsBehavioralHealth column contains a value assigned in the source and 0 if the IsBehavioralHealth column was derived. This is automatically calculated and is not expected to be populated directly (any value imported will be overwritten).
Properties
- Data type
- integer
- SQL Server data type
- tinyint
- Allows null
- No
- Default value
- 0
- Delete value
- 1
Data Lineage for Each Package
CMS ACO Part A Files Load
| IsIsBehavioralHealthFromSourceData |
CMS ACO Part B DME File Load
| IsIsBehavioralHealthFromSourceData |
CMS ACO Part B Physicians File Load
| IsIsBehavioralHealthFromSourceData |
CMS ACO Part D Prescription Drug File Load
| IsIsBehavioralHealthFromSourceData |
CMS CJR DME Claim Load
| IsIsBehavioralHealthFromSourceData |
CMS CJR Home Health Claim Load
| IsIsBehavioralHealthFromSourceData |
CMS CJR Hospice Claim Load
| IsIsBehavioralHealthFromSourceData |
CMS CJR Inpatient Claim Load
| IsIsBehavioralHealthFromSourceData |
CMS CJR Outpatient Claim Load
| IsIsBehavioralHealthFromSourceData |
CMS CJR Part B Claim Load
| IsIsBehavioralHealthFromSourceData |
CMS CJR Skilled Nursing Facility Claim Load
| IsIsBehavioralHealthFromSourceData |
Data Aggregation Medical Claim Load
| IsIsBehavioralHealthFromSourceData |
1 |
Data Aggregation Pharmacy Claim Load
| IsIsBehavioralHealthFromSourceData |
1 |
Externally Adjudicated Medical Claim Load
| IsIsBehavioralHealthFromSourceData |
1 |
Externally Adjudicated Pharmacy Claim Load
| IsIsBehavioralHealthFromSourceData |
1 |
Payer System Medical Claim Load
| IsIsBehavioralHealthFromSourceData |
1 |
Payer System Pharmacy Claim Load
| IsIsBehavioralHealthFromSourceData |
1 |
Received Claim Load
| IsIsBehavioralHealthFromSourceData |
1 |
Received Pharmacy Claim Load
| IsIsBehavioralHealthFromSourceData |
1 |
IsNonCclClaim
: integerFlag indicating if a claim has not been loaded via the Chronicles Claims Loader. This column will be set to 1 if not loaded via CCL or if the claim is deleted, 0 otherwise.
Properties
- Data type
- integer
- SQL Server data type
- tinyint
- Allows null
- No
- Default value
- 1
- Delete value
- 1
Data Lineage for Each Package
CMS ACO Part A Files Load
| IsNonCclClaim |
CMS ACO Part B DME File Load
| IsNonCclClaim |
CMS ACO Part B Physicians File Load
| IsNonCclClaim |
CMS ACO Part D Prescription Drug File Load
| IsNonCclClaim |
CMS CJR DME Claim Load
| IsNonCclClaim |
CMS CJR Home Health Claim Load
| IsNonCclClaim |
CMS CJR Hospice Claim Load
| IsNonCclClaim |
CMS CJR Inpatient Claim Load
| IsNonCclClaim |
CMS CJR Outpatient Claim Load
| IsNonCclClaim |
CMS CJR Part B Claim Load
| IsNonCclClaim |
CMS CJR Skilled Nursing Facility Claim Load
| IsNonCclClaim |
Externally Adjudicated Medical Claim Load
| IsNonCclClaim |
Externally Adjudicated Pharmacy Claim Load
| IsNonCclClaim |
Received Claim Load
| IsNonCclClaim |
Received Pharmacy Claim Load
| IsNonCclClaim |
Count
: integerArtificial measure on which calculations can be done. The value is 0 for rows marked as deleted, 1 otherwise.
Properties
- Data type
- integer
- SQL Server data type
- tinyint
- Allows null
- No
- Default value
- 1
- Delete value
- 0
_CreationInstant
: date/timeThe date and time the record was created
Properties
- Data type
- date/time
- SQL Server data type
- datetime
- Allows null
- Yes
_LastUpdatedInstant
: date/timeThe date and time the record was last updated
Properties
- Data type
- date/time
- SQL Server data type
- datetime
- Allows null
- Yes
_IsInferred
: integer1/0 column that indicates whether the record is inferred
Properties
- Data type
- integer
- SQL Server data type
- tinyint
- Allows null
- Yes
- Default value
- 0
_IsDeleted
: integer1/0 column that indicates whether the record is deleted
Properties
- Data type
- integer
- SQL Server data type
- tinyint
- Allows null
- Yes
- Default value
- 0
_PrimaryPackageToImpactRecord
: stringThe name of the primary package to impact the record
Properties
- Data type
- string
- SQL Server data type
- nvarchar(50)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- empty string
_MostRecentPackageToImpactRecord
: stringThe name of the most recent package to impact the record
Properties
- Data type
- string
- SQL Server data type
- nvarchar(50)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- empty string
_NumberOfSources
: integerThe number of sources contributing to the record
Properties
- Data type
- integer
- SQL Server data type
- smallint
- Allows null
- No
- Default value
- 0
_HasSourceClarity
: integer1/0 column that indicates whether the record is influenced by the Clarity source
Properties
- Data type
- integer
- SQL Server data type
- tinyint
- Allows null
- No
- Default value
- 0
_DeletedFromSourceClarity
: integer1/0 column that indicates whether the record is deleted from the Clarity source
Properties
- Data type
- integer
- SQL Server data type
- tinyint
- Allows null
- No
- Default value
- 0
_HasSourceCmsAco
: integer1/0 column that indicates whether the record is influenced by the CMS ACO source
Properties
- Data type
- integer
- SQL Server data type
- tinyint
- Allows null
- No
- Default value
- 0
_DeletedFromSourceCmsAco
: integer1/0 column that indicates whether the record is deleted from the CMS ACO source
Properties
- Data type
- integer
- SQL Server data type
- tinyint
- Allows null
- No
- Default value
- 0
_HasSourceCmsCjr
: integer1/0 column that indicates whether the record is influenced by the CMS CJR source
Properties
- Data type
- integer
- SQL Server data type
- tinyint
- Allows null
- No
- Default value
- 0
_DeletedFromSourceCmsCjr
: integer1/0 column that indicates whether the record is deleted from the CMS CJR source
Properties
- Data type
- integer
- SQL Server data type
- tinyint
- Allows null
- No
- Default value
- 0